Condition

Endometriosis

Clinical trials and treatment information for Endometriosis

22.3M

People Affected

Active Trials

446K

New Cases/Year

Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

Laparoscopic Excision Surgery

90% Effectiveness• 85% Confidence• 55% Safety• 42 trials• 100K participants

HIGH EvidenceGood Value

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

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Morphine💊

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DangerousModerateSafe

Time to Effect

Immediate (post-recovery)

Duration

Single procedure (long-term follow-up)

Response Rate

80%

Remission Rate

50%

Number Needed to Treat (NNT)

Common Side Effects:

Post-operative pain: 100%

Adhesions: 20%

Shoulder pain (CO2 irritation): 30%

Infection: 3%

Bleeding: 3%

Organ injury (bowel, bladder): 1%

Annual Cost of Care

Drug Cost

$200

Monitoring

$800

Side Effects

$500

Total Annual

$5,500

Cost-Effectiveness

GOOD

QALYs Gained

0.7

ICER

$80,000/QALY

Cost per Remission

$11,000

Cost per Responder

$6,875

Treatment Outcomes

Primary Outcomes

Dysmenorrhea (Menstrual Pain)7.5/10 NRS

-70% (-5.25/10 NRS)

Chronic Pelvic Pain (Non-Menstrual Pain)6.0/10 NRS

-60% (-3.6/10 NRS)

Deep Dyspareunia (Painful Intercourse)5.5/10 NRS

-50% (-2.75/10 NRS)

Endometriosis-specific Quality of Life (EHP-30 core module score)65/100 EHP-30 core score

-38.5% (-25/100 EHP-30 core score)

Secondary Benefits

Dyschezia (Painful Bowel Movements)4.0/10 NRS

-55% (-2.2/10 NRS)

Fatigue (Endometriosis-related)7/10 NRS

-30% (-2.1/10 NRS)

Pregnancy Rate (Cumulative Live Birth Rate for infertile patients)15% cumulative live birth rate over 12 months

+133.3% (+20 percentage points in cumulative live birth rate)

Common Side Effects

Post-operative pain

+100%

Adhesions

+20%

Shoulder pain (CO2 irritation)

+30%

Letrozole

88% Effectiveness• 75% Confidence• 50% Safety• 6 trials• 1K participants

MODERATE EvidenceExcellent ValueDose: 2.5mg daily

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Comparative Safety Scale(Higher is safer)

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DangerousModerateSafe

Time to Effect

1-3 months

Duration

6-12 months (with add-back therapy)

Response Rate

80%

Remission Rate

50%

Number Needed to Treat (NNT)

Common Side Effects:

Hot flashes: 80%

Joint pain (arthralgia): 40%

Fatigue: 25%

Headache: 15%

Bone mineral density loss: 15%

Annual Cost of Care

Drug Cost

$200

Monitoring

$800

Side Effects

$300

Total Annual

$1,300

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.15

ICER

$30,000/QALY

Cost per Remission

$2,600

Cost per Responder

$1,625

Treatment Outcomes

Primary Outcomes

Overall Pelvic Pain (Visual Analog Scale - VAS)70/100 points

-55% (-38.5 points)

Dysmenorrhea Severity (Visual Analog Scale - VAS)80/100 points

-60% (-48.0 points)

Non-Menstrual Pelvic Pain Severity (Visual Analog Scale - VAS)60/100 points

-45% (-27.0 points)

Ovarian Endometrioma Volume60 cm³

-40% (-24.0 cm³)

Secondary Benefits

Dyspareunia Severity (Visual Analog Scale - VAS)50/100 points

-35% (-17.5 points)

EHP-30 Pain Subscale Score65/100 points

-30% (-19.5 points)

Analgesic Use Frequency (days/week)4.5 days/week

-50% (-2.25 days/week)

Common Side Effects

Hot flashes

+80%

Joint pain (arthralgia)

+40%

Fatigue

+25%

Clinical Trial Phases:

Phase 3Phase 4

Dienogest

82% Effectiveness• 85% Confidence• 60% Safety• 37 trials• 10K participants

HIGH EvidenceGood ValueDose: 2mg daily

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Comparative Safety Scale(Higher is safer)

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DangerousModerateSafe

Time to Effect

1-3 months

Duration

Long-term (years)

Response Rate

75%

Remission Rate

45%

Number Needed to Treat (NNT)

Common Side Effects:

Irregular bleeding/spotting: 30%

Headache: 12%

Breast discomfort: 8%

Depressed mood/mood changes: 7%

Acne: 7%

Annual Cost of Care

Drug Cost

$960

Monitoring

$500

Side Effects

$100

Total Annual

$1,560

Cost-Effectiveness

GOOD

QALYs Gained

0.1

ICER

$60,000/QALY

Cost per Remission

$3,467

Cost per Responder

$2,080

Treatment Outcomes

Primary Outcomes

Overall Pelvic Pain7.5 on 0-10 VAS

-50% (-3.75 points on VAS)

Dysmenorrhea Severity7.0 on 0-10 VAS

-60% (-4.2 points on VAS)

Dyspareunia Severity6.0 on 0-10 VAS

-45% (-2.7 points on VAS)

Non-Menstrual Pelvic Pain Severity5.5 on 0-10 VAS

-40% (-2.2 points on VAS)

Secondary Benefits

Endometriosis Health Profile-30 (EHP-30) Total ScoreMean baseline score of 50 (higher score indicates worse QoL)

-30% (-15 points on EHP-30)

Analgesic ConsumptionAverage 4 days/week of analgesic use

-50% (-2 days/week of analgesic use)

Ovarian Endometrioma Volume10 cm³

-35% (-3.5 cm³)

Common Side Effects

Irregular bleeding/spotting

+30%

Headache

+12%

Breast discomfort

+8%

Clinical Trial Phases:

Phase 3Phase 4

Elagolix

80% Effectiveness• 85% Confidence• 55% Safety• 23 trials• 5K participants

HIGH EvidencePoor ValueDose: 150mg daily or 200mg twice daily

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Comparative Safety Scale(Higher is safer)

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Meth💀

Cigarettes🚬

Chemo☢️

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Morphine💊

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DangerousModerateSafe

Time to Effect

1-2 months

Duration

Up to 24 months (low dose), 6 months (high dose)

Response Rate

65%

Remission Rate

35%

Number Needed to Treat (NNT)

Common Side Effects:

Hot flashes: 35%

Headache: 18%

Nausea: 12%

Insomnia: 10%

Bone mineral density loss: 8%

Annual Cost of Care

Drug Cost

$13,000

Monitoring

$800

Side Effects

$200

Total Annual

$14,000

Cost-Effectiveness

POOR

QALYs Gained

0.12

ICER

$160,000/QALY

Cost per Remission

$40,000

Cost per Responder

$21,538

Treatment Outcomes

Primary Outcomes

Dysmenorrhea Severity1.8 on 0-3 point scale (0=none, 3=severe)

-55.6% (-1.0 point on 0-3 scale)

Non-Menstrual Pelvic Pain Severity1.5 on 0-3 point scale (0=none, 3=severe)

-46.7% (-0.7 point on 0-3 scale)

Dyspareunia Severity2.0 on 0-3 point scale (0=none, 3=severe)

-45% (-0.9 point on 0-3 scale)

Overall Pelvic Pain Severity7.0 on 0-10 Numeric Rating Scale

-40% (-2.8 points on 0-10 NRS)

Secondary Benefits

Endometriosis Health Profile-30 (EHP-30) Pain Subscale65 points on EHP-30 Pain subscale (0-100, higher=worse)

-30.8% (-20 points on EHP-30 Pain subscale)

Days per Month Requiring Opioid Analgesics5 days per month

-60% (-3 days per month)

Lost Productivity Due to Endometriosis Symptoms4 days per month

-50% (-2 days per month)

Common Side Effects

Hot flashes

+35%

Headache

+18%

Nausea

+12%

Clinical Trial Phases:

Phase 3Phase 4

Leuprolide

78% Effectiveness• 80% Confidence• 55% Safety• 28 trials• 8K participants

HIGH EvidenceModerate ValueDose: 3.75mg IM monthly

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Comparative Safety Scale(Higher is safer)

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Meth💀

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Morphine💊

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DangerousModerateSafe

Time to Effect

1-2 months (after initial flare-up)

Duration

3-6 months (with add-back therapy)

Response Rate

70%

Remission Rate

35%

Number Needed to Treat (NNT)

Common Side Effects:

Hot flashes: 75%

Headache: 20%

Mood changes/depression: 15%

Vaginal dryness: 15%

Bone mineral density loss: 8%

Flare-up effect: 15%

Annual Cost of Care

Drug Cost

$8,000

Monitoring

$1,000

Side Effects

$200

Total Annual

$9,200

Cost-Effectiveness

MODERATE

QALYs Gained

0.1

ICER

$75,000/QALY

Cost per Remission

$26,286

Cost per Responder

$13,143

Treatment Outcomes

Primary Outcomes

Pelvic Pain (NRS)7.5/10

-60% (-4.5 points)

Dysmenorrhea (NRS)8.0/10

-75% (-6.0 points)

Dyspareunia (NRS)6.0/10

-50% (-3.0 points)

Ovarian Endometrioma Diameter5.0 cm

-30% (-1.5 cm)

Secondary Benefits

Quality of Life (EHP-30 Pain Subscale Score)70/100

-40% (-28 points)

Activity Interference (BPI-SF)6.5/10

-50% (-3.25 points)

Serum Estradiol120 pg/mL

-80% (-96 pg/mL)

Common Side Effects

Hot flashes

+75%

Headache

+20%

Mood changes/depression

+15%

Clinical Trial Phases:

Phase 3Phase 4

Combined Oral Contraceptives (COCs)

68% Effectiveness• 85% Confidence• 60% Safety• 50 trials• 100K participants

HIGH EvidenceExcellent ValueDose: Standard contraceptive doses (continuous use)

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-3 months

Duration

Long-term (years)

Response Rate

65%

Remission Rate

25%

Number Needed to Treat (NNT)

Common Side Effects:

Nausea: 15%

Breast tenderness: 15%

Headache: 12%

Mood changes: 8%

Breakthrough bleeding: 7%

Venous thromboembolism: 0.1%

Annual Cost of Care

Drug Cost

$300

Monitoring

$200

Side Effects

$50

Total Annual

$550

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

ICER

$20,000/QALY

Cost per Remission

$2,200

Cost per Responder

$846

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+68%

Response Rate

+65%

Remission Rate

+25%

Common Side Effects

Nausea

+15%

Breast tenderness

+15%

Headache

+12%

Clinical Trial Phases:

Phase 4

NSAIDs (Ibuprofen, Naproxen)

45% Effectiveness• 80% Confidence• 75% Safety• 20 trials• 10K participants

MODERATE EvidenceExcellent ValueDose: Ibuprofen 200-800mg every 4-8 hours

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

30-60 minutes

Duration

As needed for pain

Response Rate

55%

Remission Rate

Number Needed to Treat (NNT)

Common Side Effects:

Gastrointestinal upset: 15%

Heartburn: 7%

Headache: 5%

Stomach ulcers/bleeding: 2%

Annual Cost of Care

Drug Cost

$30

Monitoring

$500

Side Effects

$20

Total Annual

$550

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.02

ICER

$5,000/QALY

Cost per Responder

$91

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+45%

Response Rate

+55%

Common Side Effects

Gastrointestinal upset

+15%

Heartburn

+7%

Headache

+5%

Clinical Trial Phases:

Phase 4