Role of Dienogest in Endometriosis in Young Women

Take Home Message:

Endometriosis is estimated to affect 10–15% of women of childbearing age and as much as 15–30% of those with primary or secondary infertility.

Endometriosis associated pelvic pain (EAPP) is the most common complaint of patients with endometriosis. It occurs when endometrial cells proliferate outside the uterus, for example on the ovaries or in the peritoneum. It is associated with symptoms such as chronic pelvic pain, and pain during menstruation and sexual intercourse.

Nearly, 70% of females with endometriosis present with EAPP while endometriomas are found in 17–44% of patients.

Dienogest is well tolerated drug for endometriosis showing significant relief of pain.

Dienogest is a progestogen-only hormone preparation for the treatment of endometriosis. It works by suppressing oestradiol production and preventing the growth of the endometrium.

However, it was seen that though endometriomas did not grow during treatment, significant regression was uncommon.

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Introduction

Endometriosis associated pelvic pain (EAPP) is the most common complaint of patients with endometriosis. Nearly, 70% of females with endometriosis present with EAPP while endometriomas are found in 17–44% of patients.

Material and Methods

A short-term single centre study was carried out in 56 patients in the age group of 15–35 years with complaints of pain and diagnosed as endometriosis either by imaging studies and/or by laparoscopy was given dienogest 2 mg OD, and effect of treatment was seen as improvement of pain score over a period of 3 months. The effect of dienogest was also seen on size of endometrioma. Patients were followed up at 1 and 3 months.

Results and Discussion

Out of 56 patients, 38 (67.8%) patients reported their pain relief within 2–5 days after starting dienogest. Out of 41 patients (73%) who had severe pain at enrollment, only 1 patient (1.79%) complained of severe pain at the end of 1 month with dienogest. Successful reduction in endometriotic cyst size (>50%) was seen in 3 patients (5.3%) at the end of 1 month with dienogest. Out of 56 patients, 41 patients (73.2%) had significant pain relief (>30%) at three months of treatment. At the end of 3 months, seven patients (12.5%) had significant cyst size reduction (>50%) with dienogest. No major side effects were noted.

Conclusion

Dienogest is well tolerated drug for endometriosis showing significant relief of pain. However, it was seen that though endometriomas did not grow during treatment, significant regression was uncommon.

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https://pubmed.ncbi.nlm.nih.gov/34602764/
https://link.springer.com/article/10.1007/s13224-021-01483-0

This is for informational purposes only. You should consult your clinical textbook for advising your patients.