Comparison of effectiveness in endometriosis treatment and patient acceptability between intramuscular depot-medroxyprogesterone acetate and oral desogestrel

Abstract

Objectives: To compare the effectiveness in the initial treatment of endometriosis and patient acceptability between intramuscular depot-medroxy progesterone acetate (DMPA) and oral desogestrel (DSG). Materials and Methods: A comparative study based on patient preference was conducted on women aged 18-45 years who first presented with endometriosis-like symptoms, between July 2018 and February 2019 at Maharaj Nakorn Chiang Mai Hospital. The participants were assigned to either a DMPA or DSG group based on their preference, after being informed. The primary outcome was the effectiveness of treatment for 12 weeks, measuring by visual analog score (VAS) of dysmenorrhea, dyspareunia, and chronic pelvic pain. The secondary outcome was patient acceptability in terms of level of satisfaction with the medication, quality of life, side effects, and rate of continuation. Results: Sixty-one patients, 39 in DMPA group and 22 in DSG group, were enrolled into the study. After treatment, the median VAS score for dysmenorrhea was significantly decreased in each group (DMPA: 7.61 to 2.92, p < 0.001; DSG: 7.81 to 2.86, p < 0.001) but the reduction score was not significantly different between the two groups. The quality of life (EuroQol group-5Dimensions5Levels or EQ-5D-5L) also significantly improved in both groups. Breakthrough bleeding was the most common side effect and the highest level of concern. Satisfaction and rate of continuation were not significantly different between the two groups. The acceptability rate was not significantly different. Conclusion: After 12 weeks of treatment, the effectiveness in treatment and patient acceptability in the DMPA and DSG group were comparable.