Clinical and endocrine effects of pharmacological therapy in endometriosis: a systematic review and meta-analysis

Background: Endometriosis, PCOS, adenomyosis, and dysmenorrhea are major illnesses. Hormonal as well as non-hormonal treatments were evaluated for COCs, progestins, GnRH analogues, LNG-IUS, relugolix, and adjunctive therapies. These treatments resulted in the categorization of the benefits in varying degrees. Methods: 149 clinical trials have been included. Evaluating the methodological quality was done through the Jadad scale, while the GRADE criteria were used to assess the reliability of the evidence. When these data were available, effect sizes, standardized mean differences (SMD), 95% confidence intervals (CI), and p-values were extracted. Results: It was observed that COCs and progestins considerably lowered pelvic pain and menstrual irregularities (SMD -0.35 to -0.58, 95% CI -0.90 to -0.08, p