Dienogest versus continuous oral levonorgestrel/EE in patients with endometriosis: what’s the best choice?

Ilaria Piacenti, Maria Federica Viscardi, Luisa Masciullo, Camilla Sangiuliano, Chiara Sangiuliano, Sara Scaramuzzino, Maria Grazia Piccioni, Ludovico Muzii, Pierluigi Benedetti Panici, Maria Grazia Porpora
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2021 · vol. 37(5) , pp. 471–475 · doi:10.1080/09513590.2021.1892632 · PMID:33650928 · W3135799576
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

Dienogest treatment of endometriosis demonstrated greater efficacy in reducing endometriotic lesions, pain symptoms, and improving quality of life compared to continuous levonorgestrel/EE, with similar compliance and side effects.

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Abstract

Objective Combined oral contraceptives (COC) and progestogens are widely used for the treatment of endometriosis. The objective of the study is to compare the efficacy of dienogest 2 mg vs continuous oral levonorgestrel/EE (levonorgestrel 0.1 mg/ethinyl estradiol 0.02 mg) on ovarian endometriomas, deep infiltrating endometriosis (DIE), chronic pelvic pain (CPP), dyspareunia, analgesic use, quality of life (QoL), compliance and side effects.Methods Prospective cohort study. Two cohorts of patients with endometriosis, 50 taking dienogest (group A) and 50 taking continuous levonorgestrel/EE (group B), were evaluated at the beginning of therapy (t0), after 3 (t3) and 6 months (t6). Size of endometriomas, DIE, QoL, pain symptoms, and side effects were assessed.Results Dienogest was significantly effective on CPP (p = .002), dyspareunia (p = .021) ovarian endometriomas (p = .015) and DIE lesions reduction (p = .014). Levonorgestrel/EE was significantly effective on dyspareunia (p = .023). Analgesics consumption significantly decreased in both groups (p < .001). Both treatments significantly improved the QoL. Over 6 months a significant improvement was found, more frequently in patients taking dienogest. The only side effect that both groups complained about was vaginal bleeding, present in the first 3 months of treatment (p < .001).Conclusions Both treatments are effective and safe for patients with endometriosis. Patients compliance and side effects are similar in both groups, however, there was a significantly higher reduction in endometriotic lesions, pain symptoms, and improvement of the QoL in women taking dienogest than in women taking continuous COC.

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Condition tags

mesh:D004715endometriosisdie_deep_infiltratingchronic_pelvic_paindyspareunia

MeSH descriptors

Antineoplastic Agents, Hormonal Contraceptive Agents, Hormonal Endometriosis Ethinyl Estradiol Levonorgestrel Nandrolone Adult Antineoplastic Agents, Hormonal Contraceptive Agents, Hormonal Drug Combinations Endometriosis Ethinyl Estradiol Female Humans Levonorgestrel Nandrolone Nandrolone Prospective Studies

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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.

References (34)

Cited by (33)

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