Treatment of symptomatic rectovaginal endometriosis with an oestrogen-progestogen combination versus low-dose norethindrone acetate

November 2005

Scientists in Italy have demonstrated that low-dose norethindrone acetate could be considered an effective, tolerable, and inexpensive first-choice medical alternative to repeat surgery for treating symptomatic rectovaginal endometrioti lesions in patients who do not seek conception.

In order to evaluate the efficacy, safety and tolerability of an oestrogen-progestogen combination versus low-dose norethindrone acetate, 90 women with recurrent, persistent, moderate to severe pelvic pain, following conservative surgery for rectovaginal endometriosis were recruited.

Over twelve months they received continuous treatment with oral ethinyl E2, 0.01mg, plus cyproterone acetate, 3 mg/day, OR 2.5mg norethindrone acetate/day.

At 12 months dysmenorrhea, deep dyspereunia, non-menstrual pelvic pain, and dyschezia were substantially reduced without major between-group differences. Both regimens induced minor unfavourable variations in the serum lipid profile. According to an intention-to-treat analysis, 28 (62%) out of 45 patients in the ethinyl E2 plus cyproterone acetate group and 33 (73%) out of 45 in the norethindrone acetate group were satisfied with the treatment received.


Vercellini P. Pietropaolo G, De Giorgi O, Pasin R, Chiodini A, Crosginani PG. Treatment of symptomatic rectovaginal endometriosis with an estrogen-progestogen combination versus low-dose norethindrone acetate. Fertil Steril 2005; 84(5):1375-87.

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