WHEL-C-068 · Moderate evidence · 7/10

combined oral contraceptive for endometriosis

A randomized clinical trial found that combined oral contraceptives improved endometriosis-associated pain and health-related quality of life (EHP-30) in women with endometriosis.

Origin · Existing drug · repurposing candidatePathway · 505(b)(2) · existing active ingredient, new indicationEvidence arm · Direct researchEvidence supports

How to read thisThe summary above and the proposed mechanism are generated by the model from the sources it ingested, and are written as the model’s reasoning rather than established fact. Any figure quoted from MATRIX is a model-derived association score, not a clinical measurement. How far the published record backs this pair is carried by the score’s own rigor dimension and traced to verbatim sources at the foot of the page.

Hypothesized mechanism

Hormonal suppression by combined oral contraceptives may reduce endometriosis-associated pain, though the claims do not explicitly detail the mechanism.

This is the model’s proposed mechanism from the sources on file, not a demonstrated causal pathway. How well the published record supports it is reflected in the rigor and plausibility dimensions of the score, and traced to the verbatim sources at the foot of the page.

How the score was reached, for this pair

The composite score is the sum of five dimensions, each scored 0 to 2 by the model from the evidence on file. Below is the sub-score this specific pair received on each, with what that dimension measures. It scored 7 of 10 overall, a moderate reading, from a direct rated moderate in strength.

The model’s overall reasoning for this pair is the summary at the top of the page, and the mechanism it proposed is in the section above.

Direct research arm · anchors the headline7.0 / 10 · Moderate

Scored for women. Evidence generated in women (female population, ~100% female). (band F1, ×1.00).

Corroboration

The claims derive from a single randomized clinical trial (claims 1, 2) plus a review article restating that same trial's content (claims 3, 4). This represents essentially one primary RCT, not multiple independent corroborating studies, so it scores at the low end.

1 / 2

Rigor

The primary source is explicitly a 'Randomized clinical trial' (claims 1, 2), which qualifies as RCT-level design. The accompanying review reinforces but does not add independent rigor.

2 / 2

Specificity

Both the intervention (combined oral contraceptive) and the condition (endometriosis) are named directly and repeatedly in claims 1-4, including pain and HRQoL outcomes specific to endometriosis.

2 / 2

Plausibility

The claims assert COC improves endometriosis pain and quality of life but provide no explicit mechanistic detail (e.g., hormonal suppression of ectopic endometrial tissue). The mechanism is plausible but not evidenced in the quotes.

1 / 2

Consistency

Evidence rests on a single trial with one review echoing it; there are no multiple independent studies to assess directional agreement, so consistency is scored as not penalized.

1 / 2

How the scoring rubric works, in general →

Layers not covered for this pair

Sex-specific pharmacokineticsNone on file

Not covered for this pair. This layer holds documented sex-specific pharmacokinetics for a limited set of drugs, and this compound is not among them yet. A blank here means the drug is not covered by the layer, not that no sex difference exists.

More on the sex-specific pharmacokinetics layer and its sources →

Cycle-phase dependenceNone on file

Not covered for this pair. The cycle-phase layer is seeded for the strongest-evidence cases so far (PMDD), and this pair is not among them yet. A blank here means the pair is not covered by the layer, not that the effect was found to be phase-independent.

More on the cycle-phase layer and its sources →

Source evidence · what the pipeline ingested

These are the sources the pipeline ingested to detect and score this signal, the published literature the model actually read, each tagged by study type. Where the model combined findings the claim is marked as a synthesis (S), and where the literature disagrees the contradiction is shown (!).

Every source below belongs to this signal’s evidence arm, Direct research. Whel reads each drug-condition pair through four such arms, each held to its own inclusion bar; a signal is surfaced through one of them.

1Efficacy of dienogest vs combined oral contraceptive on pain associated with endometriosis PubMed · PMID 34826668 ↗
2both dienogest and COC improved HRQoL in various core and modular segments of the EHP-30 questionnaire PubMed · PMID 34826668 ↗
3Efficacy of dienogest vs. combined oral contraceptive on pain associated with endometriosis PubMed · PMID 39159261 ↗
4comparative effects of dienogest and the combined oral contraceptive pill in women with endometriosis PubMed · PMID 39159261 ↗

These are the verbatim sources the pipeline surfaced and read; they may not be the full published record for a pair, and the score reflects the strength and agreement of the evidence rather than its volume. The strength of these source types is what the rigor dimension of the score reads off. MATRIX, sex-specific pharmacokinetics, and cycle phase are separate layers the pipeline does not ingest, external cross-references reported beside the score, and they link to their own sources in their sections above.

The primary sources and pipelines this evidence is drawn from →

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