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

Piacenti I, Ilaria Piacenti, Maria Federica Viscardi, Luisa Masciullo, Camilla Sangiuliano, Chiara Sangiuliano, Sangiuliano C, Scaramuzzino S, Sara Scaramuzzino, Maria Grazia Piccioni, Piccioni MG, Muzii L, Ludovico Muzii, Benedetti Panici P, 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
Non-randomised trial OA: closed CC0 ⤵ 33 in-corpus citations
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⚙ AI-generated summary by gemini-2.5-flash-lite, 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

endometriosisdie_deep_infiltratingchronic_pelvic_paindyspareunia

MeSH descriptors

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

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (34)

Cited by (34)

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