***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A new drug , gestrinone , was subjected to the first double blind , r and omised placebo controlled trial of any treatment of endometriosis . The disease deteriorated in eight ( 47 % ) of the 17 patients prescribed placebo ( 95 % confidence limits 23 % and 71 % ) compared with none of the 18 patients prescribed gestrinone ( p = 0.002 ) . There was a difference in elimination of the endometriosis in the gestrinone group compared with placebo but this was not statistically significant ( p = 0.057 ) . There was a significant difference in improvement of the disease in the gestrinone group compared with placebo ( p = 0.004 ) , confirming that gestrinone is an effective treatment of endometriosis . Endometriosis deteriorates in at least 23 % of patients ; as it is impossible to predict in whom this will happen , treatment appears to be warranted in all cases OBJECTIVE To compare the efficacy and safety of SC depot medroxyprogesterone acetate ( DMPA-SC 104 ) with that of leuprolide acetate in treatment of endometriosis . DESIGN Phase 3 , multicenter , r and omized , evaluator-blinded , comparator-controlled trial . SETTING Clinical trial sites in Canada and United States . PATIENT(S ) Two hundred seventy-four women with surgically diagnosed endometriosis . INTERVENTION(S ) Intramuscular injections of DMPA-SC ( 104 mg ) or leuprolide acetate ( 11.25 mg ) , given every 3 months for 6 months , with 12 months of posttreatment follow-up . MAIN OUTCOME MEASURE(S ) Reduction in five endometriosis symptoms or signs ( dysmenorrhea , dyspareunia , pelvic pain , pelvic tenderness , pelvic in duration ) ; change in bone mineral density ( BMD ) , hypoestrogenic symptoms , bleeding , and weight . RESULT ( S ) The depot medroxyprogesterone acetate given SC was statistically equivalent to leuprolide in reducing four of five endometriosis symptoms or signs at the end of treatment ( month 6 ) and in reducing all five symptoms after 12 months ' follow-up ( month 18 ) . Patients in the  DMPA-SC 104  group showed significantly less BMD loss than did leuprolide  patients at month 6 , with scores returning to baseline at 12 months ' follow-up . No statistically significant differences in median weight changes were observed between groups . Compared with leuprolide , DMPA-SC 104 was associated with fewer hypoestrogenic symptoms but more irregular bleeding . CONCLUSION ( S ) Efficacy of DMPA-SC 104 was equivalent to that of leuprolide for reducing endometriosis-associated pain , with less impact on BMD and fewer hypoestrogenic side effects but more bleeding OBJECTIVE To compare the efficacy of Dienogest versus Decapeptyl at 3.75 mg as consolidation therapy for surgery in the treatment of endometriosis . DESIGN Multicenter , open , r and omized , parallel-group clinical trial . SETTING Volunteer patients in an academic research environment . PATIENT(S ) Women with grade 2 , 3 , and 4 ( < /=70 ) endometriosis at initial laparoscopy . INTERVENTION(S ) We provided 16 weeks of treatment with Dienogest , 1 mg tablet daily ; or with Decapeptyl , 3.75 mg IM injection every 4 weeks . MAIN OUTCOME MEASURE(S ) A change in the patient 's Revised American Fertility Society score at the post-treatment laparoscopy . RESULT ( S ) From June 1994 to July 1998 , 142 patients were enrolled in the trial . After exclusion for major protocol deviations , 59 patients were included in the Dienogest group and 61 in the Decapeptyl group . This study group was comparable to the first inclusion group . The patient demographic and clinical characteristics , median duration of endometriosis , Revised American Fertility Society scores , and Visual Analogic Squale ( VAS ) scores were comparable in both groups . Statistical analysis of efficacy was not significantly different between the two groups . Adverse events were reported by 87.7 % of patients in the Dienogest group and 85.1 % in the Decapeptyl group . Neither treatment affected patient body weight or vital signs . CONCLUSION ( S ) Dienogest is as effective as Decapeptyl for consolidation therapy after surgery for the treatment of endometriosis . The safety profile of dienogest differed from Decapeptyl ( 3.75 mg ) . Dienogest constitutes a new therapeutic alternative to the GnRH analogues OBJECTIVE To assess the effect of a new progestin progestogen only pill ( desogestrel ) versus an oral contraceptive in the treatment of recurrent endometriosis . STUDY DESIGN A r and omized prospect i ve clinical study . A group of women with endometriosis ( n=40 ) who showed recurrent dysmenorrhea and /or pelvic pain after conservative surgery , and did not desire a pregnancy . Continuous treatment for 6 months with desogestrel ( 75 microg/d ) ( n=20 ) versus a combined oral contraceptive ( ethinyl estradiol 20 microg plus desogestrel 150 microg ) ( n=20 ) was performed . RESULTS A significant improvement of both pelvic pain and dysmenorrhea was observed following each type of treatment ( P<0.001 ) . The use of desogestrel progestogen only pill was associated with a breakthrough bleeding in 20 % patients , while a significant body weight increase was observed in 15 % after oral contraceptive . CONCLUSIONS Both desogestrel and an oral estro-progestinic were effective , safe and low cost therapy of pain symptoms after endoscopic surgery for endometriosis , the former showing an impact on breakthrough bleeding , the later an incidence on body weight increase BACKGROUND Dienogest is a selective progestin that has been investigated in a clinical trial programme for the treatment of endometriosis . The current non-inferiority trial compared the efficacy and safety of dienogest against leuprolide acetate ( LA ) for treating the pain associated with endometriosis . METHODS Patients with confirmed endometriosis were r and omized to treatment with dienogest ( 2 mg/day , orally ) or LA ( 3.75 mg , depot i.m . injection , every 4 weeks ) for 24 weeks . The primary efficacy variable was absolute change in pelvic pain from baseline to end of treatment , assessed by visual analogue scale ( VAS ) . Safety variables included adverse event profile , laboratory parameters , bone mineral density ( BMD ) , bone markers and bleeding patterns . RESULTS A total of 252 women were r and omized to treatment with dienogest ( n = 124 ) or LA ( n = 128 ) ; 87.9 and 93.8 % of the respective groups completed the trial . Absolute reductions in VAS score from baseline to Week 24 were 47.5 mm with dienogest and 46.0 mm with LA , demonstrating the equivalence of dienogest relative to LA .  Hypoestrogenic effects ( e.g. hot flushes ) were reported less frequently in the dienogest group . As expected , bleeding episodes were suppressed less with dienogest than with LA . Changes in mean lumbar BMD between screening and final visit were + 0.25 % with dienogest and -4.04 % with LA subgroups ( P = 0.0003 ) . Markers of bone resorption increased with LA but not dienogest . CONCLUSIONS Dienogest 2 mg/day orally demonstrated equivalent efficacy to depot LA at st and ard dose in relieving the pain associated with endometriosis , although offering advantages in safety and tolerability Danazol ( 200 mg three times a day ) and medroxyprogesterone acetate ( MPA , 100 mg a day ) were compared with placebo in the treatment of infertility of patients with endometriosis . Twenty-seven patients had medical therapy alone for 6 months , and 22 patients received it after conservative surgery . The clinical characteristics of the patients in the danazol group ( n = 18 ) , the MPA group ( n = 17 ) , and the placebo group ( n = 14 ) were comparable to each other . The follow-up time was 30 months . The cumulative pregnancy rates , 33 % in the danazol group ( n = 6 ) , 42 % in the MPA group ( n = 7 ) , and 46 % in the placebo group ( n = 6 ) , did not differ significantly from each other . The time to pregnancy after the start of therapy was 17.7 + /- 8.4 ( st and ard deviation [ SD ] ) months in the danazol group , 18.0 + /- 9.0 months in the MPA group and 10.0 + /- 5.8 months in the placebo group with no significant difference between the groups . The abortion rate was 26 % , and there was no significant difference among the groups . Cox multivariant analysis did reveal ovarian endometriosis a prognostically significant negative indicator as regards fecundation in endometriosis ( P less than 0.05 ) . In summary , correction of infertility alone does not appear to be an indication for the use of danazol or MPA in the treatment of endometriosis , and ovarian endometriotic lesions but not peritoneal ones do make a worse prognosis as regards fecundation in endometriosis OBJECTIVE To evaluate the efficacy , safety , and tolerability of an estrogen-progestogen combination versus low-dose norethindrone acetate in the treatment of persistent pain after surgery for symptomatic rectovaginal endometriosis . DESIGN R and omized controlled trial . SETTING Academic center . PATIENT(S ) Ninety women with recurrent moderate or severe pelvic pain after unsuccessful conservative surgery for symptomatic rectovaginal endometriosis . INTERVENTION(S ) Twelve-month , continuous treatment with oral ethinyl E2 , 0.01 mg , plus cyproterone acetate , 3 mg/day , or norethindrone acetate , 2.5 mg/day . MAIN OUTCOME MEASURE(S ) Degree of satisfaction with therapy . RESULT ( S ) Seven women in the ethinyl E2 plus cyproterone acetate arm and five in the norethindrone acetate arm withdrew because of side effects ( n=5 ) , treatment inefficacy ( n=6 ) , or loss to follow-up ( n=1 ) . At 12 months , dysmenorrhea , deep dyspareunia , nonmenstrual pelvic pain , and dyschezia scores were substantially reduced without major between-group differences . Both regimens induced minor unfavorable 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 . CONCLUSION ( S ) Low-dose norethindrone acetate could be considered an effective , tolerable , and inexpensive first-choice medical alternative to repeat surgery for treating symptomatic rectovaginal endometriotic lesions in patients who do not seek conception A prospect i ve , double-blind , placebo-controlled study was design ed to evaluate the clinical efficacy and tolerance of danazol and high-dose medroxyprogesterone acetate ( MPA ) in the treatment of mild-moderate endometriosis . After laparoscopical confirmation of endometriosis , 59 patients were r and omized to receive danazol ( 200 mg 3 times daily ) , MPA ( 100 mg daily ) or placebo for 6 months . Clinical examinations were done before and 1 , 3 , 6 and 12 months after the beginning of the study , and a 2nd laparoscopy 6 months after termination of the medication . Eighteen patients in the danazol  group , 16 in the  MPA group and 17 in the placebo group completed the trial . Total or partial resolution of peritoneal implants was observed in 60 % of the patients receiving danazol and in 63 % of the patients receiving MPA . In the placebo group , resolution was observed in 18 % , while the size of the implants was estimated to be increased in 23 % of the patients . In relation to placebo , danazol and MPA significantly alleviated endometriosis-associated pelvic pain , lower back pain and defecation pain , but they did not differ from each other in these actions . The appearance of acne , muscle cramps , edema , weight gain and spotting bleeding complicated MPA treatment . The present results indicate that because of good efficacy and tolerance , high-dose MPA is a useful alternative in the hormonal treatment of endometriosis The purpose of this r and omized double blind prospect i ve trial was to study the efficacy and safety of two doses of oral gestrinone in the treatment of endometriosis . Six patients received gestrinone 1.25 mg twice weekly ( group I ) and six patients received gestrinone 2.5 mg twice weekly ( group II ) . Patients underwent pretreatment and post-treatment laparoscopies  and their endometriosis scores were recorded . The mean total endometriosis scores declined significantly from 20.0 + /- 5.2 ( mean + /- st and ard error of the mean ) pretreatment to 9.5 + /-  
    Output:
    
There was no evidence of a benefit with depot administration of progestagens versus other treatments ( low dose oral contraceptive or leuprolide acetate ) for reduced symptoms .
There was no overall evidence of a benefit of oral progestagens over other medical treatment at six months of follow-up for self-reported efficacy .
Amenorrhoea and bleeding were more frequently reported in the progestagen group compared with other treatment groups .
There was no evidence of a benefit of anti-progestagens ( gestrinone ) compared with danazol .
There is only limited evidence to support the use of progestagens and anti-progestagens for pain associated with endometriosis