What the study found
Combined oral contraceptives and progestin-only pills did not show a consistent increase in negative psychological or sexual outcomes for women with endometriosis. The authors report that the available evidence generally suggests these treatments are well tolerated in relation to mood and sexual health.
Why the authors say this matters
The study suggests that these treatments may remain suitable for long-term management of endometriosis if pain remission is achieved. The authors conclude that the findings support continued use, while noting the specific concern about psychological and sexual well-being.
What the researchers tested
The researchers conducted a systematic review of PubMed, Embase, and Scopus up to August 1st, 2025. They included randomized controlled trials and non-randomized studies comparing combined oral contraceptives or progestin-only pills with no treatment in women with endometriosis, and assessed adverse events plus patient-reported mood and sexual health outcomes.
What worked and what didn't
Seven studies met the inclusion criteria: four randomized controlled trials and three observational studies. Six of seven studies reported no increased risk of psychological dysfunction, and none reported increased sexual dysfunction. Most studies reported significant pain reduction, and all six studies that specifically reported dyspareunia found benefit of treatment over placebo; no discontinuations for psychological or sexual adverse events were observed when pain remission was achieved.
What to keep in mind
The abstract notes a small number of studies, variability in measurement tools, and short follow-up, with a mean of 6 months. Risk of bias was low in randomized trials and moderate-to-serious in observational studies, and the available summary does not describe additional limitations.
Key points
- A systematic review found no consistent increase in negative psychological or sexual outcomes with combined oral contraceptives or progestin-only pills in women with endometriosis.
- Six of seven included studies reported no increased risk of psychological dysfunction, and none reported increased sexual dysfunction.
- Most studies reported significant pain reduction with treatment.
- All six studies that reported dyspareunia found benefit of treatment over placebo.
- The evidence base was small, with short follow-up and variable measurement tools.
Disclosure
- Research title:
- Combined oral contraceptives and progestin-only pills were generally well tolerated
- Authors:
- Noemi Salmeri, Martina Piccini, Francesca Caprara, Edgardo Somigliana, Paola Viganò, Paolo Vercellini
- Institutions:
- University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
- Publication date:
- 2026-03-12
- OpenAlex record:
- View
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