The effectiveness of 10 mg prednisolone on pelvic pain reduction in women with deep infiltrative endometriosis: A randomized clinical trial

Background: Despite recent progress in endometriosis treatments that modify the disease, pain continues to be the most significant symptom for many women suffering from endometriosis. Due to the role of inflammation and immune system abnormalities in the pathogenesis of endometriosis, this study aimed to determine the effectiveness of 10 mg prednisolone on pelvic pain management in women with Deep Infiltrative Endometriosis (DIE). Methods: This randomized, double blind, placebo-controlled clinical trial study was conducted with 60 women (ages 18–45 years) diagnosed with DIE. The intervention group received two tablets of prednisolone (10 mg) along with Dienogest (2 mg) daily starting from the 10th day of the first menstrual period after the baseline visit for 12 weeks. The control group received one Dienogest tablet (2 mg) daily along with two placebo tablets following the same regimen as the intervention group. Primary outcomes included changes in pain scores for dysmenorrhea, dyspareunia, and dyschezia after the intervention, as well as the change in the size of endometriosis. Results: Dysmenorrhea and dyspareunia and dyschezia scores significantly decreased in both groups. However, the frequency of patients in the prednisolone group who experienced a reduction in dysmenorrhea and dyspareunia scores ⩾30% was statistically higher compared to the control group. While the percentage of patients showing reduced endometrium size was higher in the prednisolone group (58.3% vs 36.4%), this difference was not statistically significant ( p = 0.15). No serious side effects were reported. Conclusion: This clinical trial demonstrated that low-dose prednisolone provides a significant decrease in pain associated with DIE. Further trials will be warranted to confirm these findings.