Eight studies (137 women) were included in the review, including one randomised controlled trial (RCT, n=97 women), one prospective non-randomised study (n=15 women), two non-randomised studies (n=20 women), and four case reports (n=5 women). The authors reported that the case series were poorly described and were numerically insufficient. The single RCT was characterised by adequate blinding of participants and satisfactory generation of the randomisation sequence. The length of follow-up ranged from six to 24 months.
One RCT (n=97 women) found significantly improved pain scores (p<0.001), and a non-significant trend towards benefits in bone mineral density, with the use of aromatase inhibitors and goserelin compared with the use of goserelin alone.
The remaining case reports and case series showed benefits with the use of aromatase inhibitors alongside progestogens, oral contraceptive pills or gonadotrophin-releasing hormone analogues in mean pain scores, quality of life, lesion size and bone mineral density.