Is dienogest the best medical treatment for ovarian endometriomas? Results of a multicentric case control study

Stefano Angioni, Alessandro Pontis, Maria Elena Malune, Maria E Malune, Vito Cela, Stefano Luisi, Pietro Litta, M. Vignali, Michele Vignali, Luigi Nappi
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2019 · vol. 36(1) , pp. 84–86 · doi:10.1080/09513590.2019.1640674 · PMID:31311360 · W2962367112
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Dienogest treatment of ovarian endometriomas significantly reduced cyst size and pain in patients, with comparable pain relief but greater cyst reduction than combined estro-progestins.

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Abstract

Ovarian endometriomas are common manifestations of endometriosis. Surgical excision has been shown to potentially decrease ovarian reserves. In this prospective study, we included 81 patients with ovarian endometriosis. 40 were treated with 2 mg of dienogest daily (DNG) and 41 were treated with cyclic oral estro-progestins (ethinyl estradiol 30 mcg [EE] plus dienogest 2 mg) (DNG + EE). Aim of the study was the effect of the treatment on the size of the endometriotic cysts. Further, in the symptomatic patients, follow-up included an evaluation of chronic pain before and during treatment. Both treatments were able to significantly decrease the pain in symptomatic patients with no statistical differences. The mean visual analog scale score at enrollment was 65 ± 14 and 70 ± 18, and there was significant improvement (19 ± 15, p < .001, DNG; 18 ± 12, p < .001, DNG + EE). The size of the endometrioma cysts were significantly reduced in the DNG group. The mean cyst diameter was 52 ± 22 mm at baseline and 32 ± 12 mm after six months of treatment (p < .001), yielding a 75% volume reduction in DNG group. The decrease in the size of endometrioma cysts observed in the women treated with only progestin could be noteworthy, as it may reduce the negative impacts on the affected ovary and avoid surgery.

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Condition tags

endometriosischronic_pelvic_painendometrioma

MeSH descriptors

Contraceptives, Oral, Combined Endometriosis Ethinyl Estradiol Hormone Antagonists Nandrolone Ovarian Diseases Adult Case-Control Studies Contraceptives, Oral, Combined Endometriosis Endometriosis Endometriosis Endometriosis Ethinyl Estradiol Female Hormone Antagonists Humans Nandrolone Nandrolone Ovarian Diseases

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