Role of Dienogest in Endometriosis in Young Women

Abstract

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 DiscussionOut 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.

Medical Management of Ovarian Endometriomas

“…Twenty-three studies had cyst size change as a primary outcome, only four of which included a sample size calculation powered to detect change in size. 15,17,22,35…”

“…Among these, 32 studies were excluded for the following reasons: abstract only or conference proceeding (n520), absence of extractable data (n55), full text not available (n54), ineligible setting (n52), absent outcome of interest (n51). The remaining full-text articles included in this systematic review originated from Italy, [7][8][9][10][11][12][13][14][15][16][17][18] Japan, [19][20][21][22][23][24][25][26][27][28][29] Turkey, 4,30,31 the United States, [32][33][34] India, 35 Thailand, 36 Denmark, 37 and the United Arab Emirates. 38 See Figure 1 for the PRISMA flow diagram.…”

Efficacy of Dienogest in Adolescent Endometriosis: A Narrative Review

“…They discovered that giving young women DNG at a dose of 1 mg per day for three months had no appreciable impact on bone turnover during the bone-growth phase. DNG was found to be generally well tolerated in clinical trials [9][10][11][12]. Here is an understanding of the biological factors of different progesterones used in endometriosis [13] (Table 1).…”

“…Malik and Mann [ 9 ] carried out a short-term single-centre study on the “Role of Dienogest in Endometriosis in Young Women” among 56 patients between the ages of 15 and 35 years who complained of pain and were laparoscopically or by imaging examinations identified as having endometriosis. DNG 2 mg once daily was administered to the patients, and the treatment's results were seen over the course of three months by an improvement in pain score.…”

“…Thirty-eight (67.2%) out of the 56 patients reported experiencing pain relief between two and five days after starting DNG, according to Malik and Mann [ 9 ]. Forty-one out of the 56 patients had significant pain at enrollment, and only one (1.79%) reported severe pain at the conclusion of the first month on DNG.…”