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Contraception and endometriosis: challenges, efficacy, and therapeutic importance

Authors Weisberg E, Fraser I

Received 24 July 2014

Accepted for publication 15 April 2015

Published 27 July 2015 Volume 2015:6 Pages 105—115


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Igal Wolman

Edith Weisberg,1 Ian S Fraser2

1Family Planning NSW, 2School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia

Abstract: Endometriosis is a benign gynecological condition that is estimated to affect 10% of women in the general population and appears to be increasing in incidence. It is an estrogen-dependent inflammatory disease, and is primarily characterized by dysmenorrhea, deep dyspareunia, chronic pelvic pain, and variable effects on fertility. The symptoms may greatly affect quality of life, and symptom control may be the primary aim of initial management, while contraceptive effect is often secondary. It is estimated that 30%–50% of women with endometriosis have an infertility problem, so a considerable number of endometriosis sufferers will require effective, planned contraception to maximize “protection of fertility” and prevent progression of the endometriotic condition. Ideally, this contraception should also provide symptom relief and improvement of physical, mental, and social well-being. At the present time, long-term progestogens appear to be the most effective choice for meeting all of these requirements, but other options need to be considered. It is becoming increasingly recognized that hormonal contraceptive systems are necessary for prevention of disease recurrence following surgical treatment of endometriosis. The personal preferences of the woman are an integral part of the final contraceptive choice. This article discusses the advantages and disadvantages of the contraceptive options available to women with endometriosis.

Keywords: pelvic pain, disease recurrence, progestogens, delivery systems, long-acting

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