| Study | Intervention/comparison | Population | Outcomes | Comments |
|---|---|---|---|---|
| Chen 2012 China | Intervention: Abdominal acupuncture, administered prior to and during menses for 3 consecutive menstrual cycles. Acupuncture was performed approximately 7 times during each treatment cycle Comparison: Danazol, 200mg twice daily was administered (starting on day 1 of a menstrual cycle), for 3 consecutive cycles | Severity of endometriosis symptoms:
N=70 | Assessed at 6 months (3 months of treatment, then 3 months without treatment). Cure of symptoms – defined as complete relief of pain and other symptoms after medication and no relapse in the next 3 menstrual cycles | |
| de Sousa 2016 Brazil | Intervention: experimental treatment of acupuncture, 5 sessions of acupuncture in 5 weeks Comparison: sham-acupuncture, 5 sessions of acupuncture in 5 weeks | Mean age of 30.81 years (±6.38). These women were suffering from endometriosis for an average of 4.79 years (±2.48). No other information given. N=42 | All outcomes measured at 2 months (follow up). Pain score (VAS of 0–10) for:
| |
| Flower 2011 UK | Intervention: an individualised CHM decoction was administered twice daily for 16 weeks Comparison: a placebo decoction comprising inactive ingredients was administered twice daily for 16 weeks | 15% of participants were using concomitant medical therapy (not described). N=33 | Assessed at the end of treatment (16 weeks) Pain scores, measured with VAS 0–10:
Endometriosis Health Profile-30 scores (range 0–100) | |
| Mira 2015 Brazil | Intervention: acupuncture-like TENS to S3–S4 region, 30 minute sessions were applied once a week for a period of 8 weeks Comparison: self-applied TENS to the S3–S4 region, 20 minute sessions were conducted twice daily for a period of 8 weeks | Women with deep endometriosis diagnosed in the cul-de-sac and intestinal loop who sustained pelvic pain and/or deep dyspareunia, despite continuous clinical medication. All women were undergoing hormone therapy with continuous progestin alone or combined oral contraceptives for at least 3 months. N=22 | Assessed at the end of treatment (8 weeks). Endometriosis Health Profile-30 scores (range 0–100) | Women were undergoing hormone therapy with continuous progestin alone or combined contraceptives for at least 3 months |
| Sesti 2009 Italy | Intervention: Group 1: GnRH analogue 3.75mg every 28 days post-operatively Group 2: continuous lowdose cOCP for 6 months post-operatively Group 3: dietary intervention (including probiotics, vitamin, mineral and fatty acid supplementation) postoperatively Comparison: placebo | All women underwent laparoscopic cystectomy for endometrioma at the start of the trial. N=259 | Assessed at 18 months follow up: recurrence of endometrioma >20mm diameter. Cysts suspected to be endometriomas with ultrasound were then confirmed laparoscopically | Women with an endometrioma, who underwent cystectomy at the start of the trial. |
| Wayne 2008 USA | Intervention: Japanese-style acupuncture, twice per week for 8 consecutive weeks Comparison: sham-acupuncture, twice per week for 8 consecutive weeks | All women had stage I endometriosis. Eligible participants were aged 13–22 years old. N=18 | All outcomes measured at 4 weeks, 8 weeks (during treatment) and 6 months (follow up). Pain score (numerical analogue scale of 0–10). Endometriosis Health Profile-30 (range 0–100). Pediatric Quality of Life Inventory score (range 0–100). Activity scale (to assess activities limited by endometriosis) (range 0–10) | |
| Wu 2006 (Flower 2012 CSR) China | Intervention: CHM Group 1: Nei Yi pills 10g twice daily Group 2: Nei Yi pills 10g twice daily plus Nei Yi enema 70ml once daily Comparison: danazol 400mg per day | Laparoscopically confirmed endometriosis. No other details given N=58 | Symptomatic relief was assessed within 3 years of stopping treatment, other outcomes – at the end of 3 months treatment. Five outcomes were assessed:
| |
| Xia 2006 China | Intervention: acupuncture (started 9 days before menses and discontinued during menses) and CHM (GuiZhi-Fu-Ling-Wan) Comparison: danazol 200mg twice daily. Treatment was continued for 3 consecutive cycles | N=78 | Assessed at the end of treatment (3 months of treatment). Dysmenorrhoea (pain scale not reported). Dichotomous outcome of ‘cessation of signs and symptoms’ of
| |
| Xiang 2002 China | Intervention: Ear acupuncture therapy, beginning 5 days before menses and given fo4ur times every other day, for 3 menstrual cycles Comparison: CHM. A decoction was given 5 days before menstruation, 1 dose for 7 days, for 3 menstrual cycles | Laparoscopically confirmed endometriosis. No other information given. N = 67 | Assessed at the end of treatment (3 menstrual cycles). Dysmenorrhoea score (5–15). Symptom cure (dichotomous outcome) | |
| Zhu 2014 China | Intervention: Group 1: cOCP (30μg ethinyloestradiol and 150μg desogestrel) administered once per day for 63 days after surgery Group 2: as group 1, but also received Dan’e CHM 30g per day for the latter 30 days of treatment. Comparison: no medical treatment after surgery | Women with minimal/mild endometriosis (wishing to conceive), who had failed to become pregnant after at least 12 months of unprotected intercourse. All women underwent surgery at the start of the trial, including ablation/excision of all visible lesions and division of adhesions to restore normal pelvic anatomy N=156 | Fertility outcomes assessed at 12 months after treatment:
| Women with subfertility and minimal/mild endometriosis, all of whom underwent operative laparoscopy at the start of the trial |
N: number of participants in study; CSR: Cochrane systematic review
From: 11, Management strategies
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