A randomized controlled trial of goserelin and medroxyprogesterone acetatein the treatment of pelvic congestion

Following identification of the proportion of pelvic congestion among sympt omatic patients complaining of chronic pelvic pain, and in a totally asympt omatic group of patients requesting tubal ligation, the efficiency of goser elin acetate versus medroxyprogesterone acetate was compared objectively us ing pelvic venogram scores, and subjectively by symptom resolution, improve ment of psychological status and sexual functioning in a prospective random ized trial in 47 patients with pure pelvic congestion syndrome. Patients re ceived either goserelin acetate (3.6 mg/month for 6 months) or medroxyproge sterone acetate (MPA; 30 mg/day for 6 months). Among patients with chronic pelvic pain, those with pure pelvic congestion were mostly parous, had the most severe pelvic signs and symptom scores, lowest rates of sexual functio ning, and higher states of anxiety and depression as compared with others. At 1 year after treatment, goserelin remained superior to MPA in terms of p elvic venographic improvement as an objective measure. In alleviation of si gns and symptomatology, improvement of sexual functioning and reduction of anxiety and depressive states as subjective measures, goserelin acetate ach ieved a statistically significant advantage (P = 0.0001) compared with MPA.