Oral contraceptive pill as treatment for primary dysmenorrhoea (updated)

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dc.contributor.author Wong, CL en
dc.contributor.author Farquhar, Cynthia en
dc.contributor.author Roberts, Helen en
dc.contributor.author Proctor, M en
dc.date.accessioned 2011-12-05T19:46:34Z en
dc.date.issued 2009 en
dc.identifier.citation Cochrane Database of Systematic Reviews 50 pages Article number CD002120 2009 en
dc.identifier.issn 1469-493X en
dc.identifier.uri http://hdl.handle.net/2292/9780 en
dc.description.abstract Background Dysmenorrhoea (painful menstrual cramps) is common. Combined OCPs are recommended in the management of primary dysmenorrhoea. Objectives To determine the effectiveness and safety of combined oral contraceptive pills for the management of primary dysmenorrhoea. Search strategy We conducted electronic searches for randomised controlled trials (RCTs) in the Cochrane Menstrual Disorders and Subfertility Group Register of controlled trials CENTRAL, CCTR, MEDLINE, EMBASE, and CINAHL (first conducted in 2001, updated on 5 November 2008). Selection criteria RCTs comparing all combined OCPs with other combined OCPs, placebo, no management, or management with nonsteroidal anti-inflammatories (NSAIDs) were considered. Data collection and analysis Twenty three studies were identified and ten were included. Six compared the combined OCP with placebo and four compared different dosages of combined OCP. Main results One study of low dose oestrogen and four studies of medium dose oestrogen combined OCPs compared with placebo, for a combined total of 497 women, reported pain improvement. For the outcome of pain relief across the different OCPs the pooled OR suggested benefit with OCPs compared to placebo (7 RCTs: Peto OR 2.01 [95% CI 1.32, 3.08]).The Chi-squared test for heterogeneity showed there is significant heterogeneity with an I2 statistic of 64% and a significant chi-square test (14.06, df=5, p=0.02). A sensitivity analysis removing the studies with inadequate allocation concealment suggested significant benefit of treatment with the pooled OR of 2.99 (95% CI 1.76, 5.07) and heterogeneity no longer statistically significant and I2 statistic of 0%. Three studies reported adverse effects (Davis 2005; Hendrix 2002; GPRG 1968) The adverse effects were nausea, headaches and weight gain. Two studies reported if women experienced any side effect and no evidence of an effect was found (3 RCTs: OR = 1.45 (95% 0.71, 2.94). There was no evidence of statistical heterogeneity. There were no studies identified that compared combined OCP versus non steroidal anti-inflammatory drugs There was no evidence of a difference for the pooled studies for 3rd generation pro gestagens (OR = 1.11 (95% CI 0.79 - 1.57)). For the 2nd generation versus 3rd generation the OR was 0.44 (95% CI 0.23-0.84) suggesting benefit of the 3rd generation OCP but this was for a single study (Winkler 2003). Authors' conclusions There is limited evidence for pain improvement with the use of the OCP (both low and medium dose oestrogen) in women with dysmenorrhoea. There is no evidence of a difference between different OCP preparations. en
dc.publisher John Wiley & Sons, Ltd. en
dc.relation.ispartofseries Cochrane Database of Systematic Reviews en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/1469-493X/ en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri http://www.thecochranelibrary.com/view/0/PermissionsReprints.html en
dc.title Oral contraceptive pill as treatment for primary dysmenorrhoea (updated) en
dc.type Journal Article en
dc.identifier.doi 10.1002/14651858.CD002120.pub3 en
pubs.issue 4 en
dc.rights.holder Copyright: 2009 The Cochrane Collaboration en
dc.identifier.pmid 19370576 en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype Review en
pubs.elements-id 93928 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Obstetrics and Gynaecology en
pubs.number CD002120 en
pubs.record-created-at-source-date 2010-09-01 en
pubs.dimensions-id 19370576 en

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