Archives of Gynecology and Obstetrics

, Volume 292, Issue 1, pp 37–43 | Cite as

Continuous versus cyclic oral contraceptives for the treatment of endometriosis: a systematic review

  • Konstantinos A. Zorbas
  • Konstantinos P. EconomopoulosEmail author
  • Nikos F. Vlahos



Recurrence of endometriosis after conservative surgery has been observed in 40–50 % of patients within the first 5 years. A variety of regimens such as combined oral contraceptives, GnRH agonists, danazol, and progestins have been used postoperatively to reduce recurrence rates. Oral contraceptives (oCP) have been used either in a cyclic or in a continuous (no pill-free interval) fashion. The purpose of this article was to summarize the existing evidence on the efficacy and patient compliance for the use of oCP in a continuous versus cyclic fashion following conservative surgery for endometriosis.


A systematic search of Medline identified four eligible studies. Studies were considered eligible, if they have evaluated oCP therapy, either in a cyclic or continuous regimen, after conservative surgery for endometriosis. Specifically, studies (1) reporting on women with endometriosis who were treated postoperatively with both continuous oCP and cyclic oCP, (2) written in English, (3) with minimum 6 months duration of medical treatment, and (4) with minimum 12 months duration of follow-up were considered eligible for our systematic review. Outcome measures of these eligible studies were tabulated and then analyzed cumulatively. A purely descriptive approach was adopted concerning all variables.


Postoperative use of continuous oCP was associated with a reduction in the recurrence rate of dysmenorrhea, delay in the presentation of dysmenorrhea, reduction in nonspecific pelvic pain, and reduction in the recurrence rate for endometrioma.


Use of oCP in a continuous fashion following conservative surgery for endometriosis is more beneficial to cyclic use.


Endometriosis Continuous Cyclic Oral contraceptives Pelvic pain Dysmenorrhea 


Conflict of interest

We declare that we have no conflict of interest.

Supplementary material

404_2015_3641_MOESM1_ESM.doc (62 kb)
Supplementary material 1 (DOC 62 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Konstantinos A. Zorbas
    • 1
    • 2
  • Konstantinos P. Economopoulos
    • 2
    • 3
    Email author
  • Nikos F. Vlahos
    • 4
  1. 1.Department of Obstetrics and GynecologyGeneral Hospital of VeriaVeriaGreece
  2. 2.Society of Junior DoctorsAthensGreece
  3. 3.Department of SurgeryMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  4. 4.Second Department of Obstetrics and Gynecology, Aretaieion HospitalUniversity of Athens School of MedicineAthensGreece

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