Medical treatment of ovarian endometriomas: a prospective evaluation of the effect of dienogest on ovarian reserve, cyst diameter, and associated pain

Ludovico Muzii, Giulia Galati, Chiara Di Tucci, Mara Di Feliciantonio, Giorgia Perniola, Violante Di Donato, Pierluigi Benedetti Panici, Michele Vignali, M. Vignali
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2019 · vol. 36(1) , pp. 81–83 · doi:10.1080/09513590.2019.1640199 · PMID:31304853 · W2959862727
article OA: closed CC0 ⤵ 39 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study found that 6-month dienogest treatment significantly reduced ovarian endometrioma size and pain, while preserving ovarian reserve by increasing antral follicle count without significantly altering AMH levels.

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Abstract

The aim of the present study was to evaluate the effect of medical treatment of ovarian endometriomas on cyst diameter, associated pain, and ovarian reserve as measured with antral follicle count (AFC) and anti-Mullerian hormone (AMH). In this prospective study, 32 patients with unilateral endometrioma associated with pelvic pain, underwent 6-month medical treatment with dienogest. Before treatment, and at the end of 6 months of treatment, patients underwent evaluation of endometrioma diameter and AFC at transvaginal ultrasonography, measurement of AMH, and evaluation of associated pain. Mean cyst diameter was 4.0 ± 1.3 cm at baseline, and 2.4 ± 1.2 cm after 6 months of treatment (p < .0001), for a reduction in diameter of 40% and a reduction in volume of 79%. Mean visual analog scale score at enrollment was 6.3 ± 2.0, with a significant improvement at 6 months (0.9 ± 1.0, p < .0001). AFC for the affected ovary improved from 4.2 ± 2.8 at baseline, to 8.6 ± 4.2 cm after 6 months (+105%; p < .0001). AMH did not change significantly from baseline (3.40 ± 2.32 ng/mL) to end of treatment (2.80 ± 1.90 ng/mL, –18%, p = .27). Medical treatment with dienogest significantly reduces endometrioma diameter and associated pain, whereas the ovarian reserve appears to be preserved, with a significant improvement of AFC and no significant change in AMH.

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Condition tags

endometriosischronic_pelvic_painendometrioma

MeSH descriptors

Endometriosis Hormone Antagonists Nandrolone Ovarian Diseases Ovarian Follicle Ovarian Reserve Pelvic Pain Adult Anti-Mullerian Hormone Anti-Mullerian Hormone Endometriosis Endometriosis Endometriosis Endometriosis Female Hormone Antagonists Humans Nandrolone Nandrolone Ovarian Diseases

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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.

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Cited by (39)

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