Objective: To evaluate the efficacy of continuous oral contraceptive (OC) use versus the usual cyclic fashion in the recurrence of endometriosis-related symptoms after surgery.

Design: Prospective cohort trial involving patients in two tertiary care units.

Setting: Academic institution in collaboration with a private hospital.

Patient(s): 356 patients underwent surgical treatment by laparoscopy for symptomatic endometriosis.

Intervention(s): After surgical treatment for endometriosis, patients offered 6-month course of cyclic OC (including a 7-day pill-free period) or continuous OC.

Main Outcome Measure(s): Recurrence rate of endometriosis-related symptoms and endometriomas after fertility-sparing surgery.

Result(s): Out of 356 patients, 167 were placed on the usual cyclic OC course and 85 on continuous OC for a minimum of 6 months. The continuous OC group experienced a statistically significant reduction in recurrence rates for endometrioma, dysmenorrhea, and non-menstrual pelvic pain as compared with the cyclic OC group. There was no reduction in the recurrence of dyspareunia between the two groups.

Conclusion(s): After surgical treatment of endometriosis, the use of both cyclic and continuous OC improves pain symptoms when compared with preoperative scores. Continuous OC appears to be associated with a reduced recurrence rate for dysmenorrhea, non-menstrual pelvic pain, and endometrioma but not for dyspareunia as compared with cyclic OC.

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http://dx.doi.org/10.1016/j.fertnstert.2013.07.008DOI Listing

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