{"paper_id":"a63f6cd8-c0ac-4834-b162-983a135cec59","body_text":"Abstract\nThe aim of this study was to evaluate the changing pattern of bone mineral density (BMD) levels after 3 years of dienogest use post endometrioma surgery and investigate the possible predictive factors for BMD reduction. This retrospective study included 44 reproductive-aged women who took dienogest (2 mg/day) and followed up BMD for 3 years after laparoscopic endometrioma surgery from July 2013 to December 2018. In addition, to investigate the predictive factors in the group with decreased BMD, analysis was added for patients with decreased BMD after taking dienogest for 1 year post laparoscopic endometrioma surgery. After 3 years of treatment with dienogest, BMD of both the lumbar spine (− 4.4%) and femur neck (− 3.6%) decreased significantly compared to the baseline levels. Bone loss predominantly occurred during the first year of treatment in the lumbar spine (− 2.4%) and gradually decreased with time during the treatment period. The predictive factors for BMD reduction after dienogest use were evaluated based on a 1-year change in BMD levels of 160 women, but no associated factors were found. This study demonstrated that dienogest use for 3 years was associated with a significant and gradual decrease in BMD and no predictive factors for BMD reduction during the first year of treatment with dienogest were found. These results may be useful in counseling patients regarding long-term effects of dienogest use on reducing BMD levels so that appropriate preventive measures can be taken.\nSimilar content being viewed by others\nData Availability\nNot applicable.\nReferences\nGiudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789–99.\nEisenberg VH, Weil C, Chodick G, Shalev V. 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Writing the article: Sung Eun Kim, Dong-Yun Lee, and DooSeok Choi.\nCorresponding author\nEthics declarations\nConflict of Interest\nThe authors declare that they have no conflict of interest.\nEthics Approval\nAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This retrospective study was granted approval by the Institutional Review Board on Samsung Medical Center (IRB approval number: 2019-07-145).\nConsent to Participate\nThe requirement for required consent was waived due to the retrospective nature of this study.\nConsent for Publication\nNot applicable.\nCode Availability\nNot applicable.\nAdditional information\nPublisher’s Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nKim, S.E., Lim, HH., Lee, DY. et al. The Long-Term Effect of Dienogest on Bone Mineral Density After Surgical Treatment of Endometrioma. Reprod. Sci. 28, 1556–1562 (2021). https://doi.org/10.1007/s43032-020-00453-7\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s43032-020-00453-7","source_license":"CC0","license_restricted":false}