Impact of Dienogest Alone or in Combination with Ethinylestradiol on the Quality of Life of Women with Endometriosis: A Prospective Cohort Study

Mujde Canbay, Süleyman Salman
In: Gynecology Obstetrics & Reproductive Medicine · 2023 · pp. 1–10 · doi:10.21613/gorm.2023.1453 · W4390140148
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This study found no significant difference in quality of life, CA-125, or AMH levels between women with endometriosis treated with dienogest alone or combined with ethinylestradiol.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This prospective cohort study enrolled women with endometriosis diagnosed by compatible gynecologic examination (per ESHRE/ASRM criteria), imaging, or prior surgery pathology, and compared two oral treatment regimens: dienogest 2 mg plus ethinylestradiol 0.03 mg versus dienogest 2 mg alone. SF-36 quality-of-life scores and baseline cancer antigen-125 (CA-125) and anti-Müllerian hormone (AMH) values were recorded, with post-treatment outcomes assessed for differences between groups. The study found no significant between-group differences in quality of life before or after treatment, nor in endometrioma size, CA-125, or AMH levels, and reported similar patient characteristics across groups. This paper is centrally about endometriosis — it directly compares dienogest alone versus dienogest plus ethinylestradiol on quality of life and biochemical markers in women with endometriosis.

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Abstract

OBJECTIVE: We aim to compare the effectiveness of oral contraceptives and dienogest, primarily by considering the quality of life scale. We also aim to compare the Cancer Antigen-125 and Anti-mullerian Hormone values. STUDY DESIGN: Gynecological examination findings evaluated based on ESHRE and ASRM Guideline criteria are compatible with endometriosis, or a previous surgery pathology result is consistent with endometriosis, and patients whose imaging report was compatible with endometriosis were selected. Among the patients who were recommended medical treatment, patients selected as Dionegest 2mg+Ethinylestradiol 0.03 mg (Dienelle) treatment were considered Group 1, and patients deemed suitable for treatment with treatment 2mg Dionegest (Visanne) were considered Group 2. Pre-treatment Cancer Antigen-125/Anti-mullerian Hormone values and SF-36 were recorded. RESULTS: There was no significant difference between drug groups in terms of education status, body mass index, family history, smoking, alcohol consumption, age, age at menarche, menstruation pattern, duration of menstruation, infertility, gestational status, job loss due to pain complaints, operation, and MRI findings (p>0.05). There was no significant difference between the drug groups regarding the quality of life before and after treatment (p>0.05). There was no significant difference between drug groups regarding endometrioma size, Cancer Antigen-125, and anti-mullerian hormone findings (p>0.05). CONCLUSION: Evaluating our data, the efficacy and success of the two treatment protocols were the same. It seems more logical to prefer cost-effective oral contraceptive treatments with a low side-effect profile than high-cost Dionegest. Following the guidelines accepted step therapy in treating mild or moderate endometriosis, cyclic oral contraceptives may be recommended as first-line therapy.
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Objective

We aim to compare the effectiveness of oral contraceptives and dienogest, primarily by considering the quality of life scale. We also aim to compare the Cancer Antigen-125 and Anti-mullerian Hormone values. STUDY DESIGN: Gynecological examination findings evaluated based on ESHRE and ASRM Guideline criteria are compatible with endometriosis, or a previous surgery pathology result is consistent with endometriosis, and patients whose imaging report was compatible with endometriosis were selected. Among the patients who were recommended medical treatment, patients selected as Dionegest 2mg+Ethinylestradiol 0.03 mg (Dienelle) treatment were considered Group 1, and patients deemed suitable for treatment with treatment 2mg Dionegest (Visanne) were considered Group 2. Pre-treatment Cancer Antigen-125/Anti-mullerian Hormone values and SF-36 were recorded.

Results

There was no significant difference between drug groups in terms of education status, body mass index, family history, smoking, alcohol consumption, age, age at menarche, menstruation pattern, duration of menstruation, infertility, gestational status, job loss due to pain complaints, operation, and MRI findings (p>0.05). There was no significant difference between the drug groups regarding the quality of life before and after treatment (p>0.05). There was no significant difference between drug groups regarding endometrioma size, Cancer Antigen-125, and anti-mullerian hormone findings (p>0.05).

Conclusion

Evaluating our data, the efficacy and success of the two treatment protocols were the same. It seems more logical to prefer cost-effective oral contraceptive treatments with a low side-effect profile than high-cost Dionegest. Following the guidelines accepted step therapy in treating mild or moderate endometriosis, cyclic oral contraceptives may be recommended as first-line therapy. Downloads Downloads Published How to Cite Issue Section License Copyright (c) 2023 Mujde Canday, Suleyman Salman This work is licensed under a Creative Commons Attribution 4.0 International License. All the articles published in GORM are licensed with "Creative Commons Attribution 4.0 License (CC BY 4.0)". This license entitles all parties to copy, share and redistribute all the articles, data sets, figures and supplementary files published in this journal in data mining, search engines, web sites, blogs and other digital platforms under the condition of providing references.

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Condition tags

endometriosisendometriomainfertility

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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