{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:31:12Z","timestamp":1792809072194,"version":"4.5.0"},"reference-count":71,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:00:00Z","timestamp":1731888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Endometriosis is a chronic condition that affects 6\u201310% of women of reproductive age, with pain and infertility being its primary symptoms. The most common aspects of pain are overall pelvic pain, dysmenorrhea, and dyspareunia. Our aim was to compare the available medical treatments for endometriosis-related pain. Methods: A systematic search was conducted in three medical databases to assess available drug options for pain management. Randomized controlled trials (RCTs) investigating various medical treatments for endometriosis-related pain on different pain scales were included. Results were presented as p-scores and, in cases of placebo controls, as mean differences (MD) with 95% confidence intervals (CI). From the available data, a network meta-analysis was carried out. Results: The search yielded 1314 records, of which 45 were eligible for data extraction. Eight networks were created, and a total of 16 treatments were analyzed. The highest p-score, meaning greatest pain relief (p-score: 0.618), for the treatment of dysmenorrhea was achieved using gonadotropin-releasing hormone (GnRH) agonists for 3 months on a scale of 0\u2013100. Additionally, a p-score of 0.649 was attained following a 6-month treatment with GnRH agonists combined with hormonal contraceptives (CHCs). In the case of dyspareunia on a scale of 0\u2013100 following 3 months of treatment, CHCs (p-score: 0.805) were the most effective, and CHCs combined with aromatase inhibitors (p-score: 0.677) were the best treatment option following 6 months of treatment. In the case of overall pelvic pain, CHCs (p-score: 0.751) yielded the highest p-score on a scale of 0\u2013100 following 3 months of treatment, and progestins combined with aromatase inhibitors (p-score: 0.873) following 6 months of treatment. Progestins (p-score: 0.901) were most effective in cases of overall pelvic pain on a scale of 0\u20133 following 3 months of treatment. Conclusions: Our network meta-analysis showed that in cases of dysmenorrhea, GnRH agonists supplemented with CHCs reduced pain the most following 3 months of treatment. Regarding dyspareunia CHCs were most effective, and in the case of overall pelvic pain, CHCs or progestins combined with aromatase inhibitors yielded the most desirable results.<\/jats:p>","DOI":"10.3390\/jcm13226932","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T10:44:37Z","timestamp":1732013077000},"page":"6932","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Comparative Analysis of Medical Interventions to Alleviate Endometriosis-Related Pain: A Systematic Review and Network Meta-Analysis"],"prefix":"10.3390","volume":"13","author":[{"given":"\u00c1d\u00e1m","family":"Csirz\u00f3","sequence":"first","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e9nes P\u00e9ter","family":"Kov\u00e1cs","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anett","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Urology, Semmelweis University, 1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bence","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1rp\u00e1d","family":"Jank\u00f3","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Hegyi","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Institute of Pancreatic Diseases, Semmelweis University, 1083 Budapest, Hungary"},{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Nyir\u00e1dy","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Urology, Semmelweis University, 1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-1869","authenticated-orcid":false,"given":"N\u00e1ndor","family":"\u00c1cs","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1098-1861","authenticated-orcid":false,"given":"S\u00e1ndor","family":"Valent","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/j.molmed.2018.07.004","article-title":"The Immunopathophysiology of Endometriosis","volume":"24","author":"Symons","year":"2018","journal-title":"Trends Mol. 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