Dienogest versus gonadotropin-releasing hormone analogue for the clinical treatment of endometriosis: a systematic review and meta-analysis

Sofia Andrade, Bárbara Souza Melo, Marina Fernandes Pereira
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2017 · vol. 6(9) , pp. 3712 · doi:10.18203/2320-1770.ijrcog20174013 · W2745747978
review OA: diamond CC0 ⤵ 3 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This meta-analysis found dienogest and GnRH analogues showed no difference in treating pelvic pain, dyspareunia, or pouch of Douglas induration, but dienogest had fewer headaches and less BMD loss.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This systematic review and meta-analysis compared dienogest with gonadotropin-releasing hormone (GnRH) analogues for clinical treatment of endometriosis, using four eligible studies selected from 31 articles. Across evaluations of maintenance of lower abdominal/pelvic pain, dyspareunia, induration of the Pouch of Douglas after treatment, and side effects (including hot flushes, headache, and bone mineral density loss), the review found no difference between the groups for pain, dyspareunia, induration, or hot flushes. However, the dienogest group had a lower incidence of headache and less bone mineral density loss. The main caveat is that only four studies met inclusion criteria, limiting the breadth of evidence contributing to the pooled comparisons. This paper is centrally about endometriosis — it directly meta-analyzes dienogest versus GnRH analogues for symptom control and side-effect outcomes in endometriosis.

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Abstract

Endometriosis is a chronic inflammatory disease, defined by the presence of endometrial tissue outside the uterine cavity. It causes symptoms such as dysmenorrhea, chronic pelvic pain, dyspareunia, infertility, with great loss of quality of life for the patient. The objective of the study was to compare, through a meta-analysis, GnRH analogues, which are considered clinical first line treatment for endometriosis, versus dienogest, a selective oral progestin in the treatment of endometriosis. A systematic review was conducted to select the studies. In total, 31 articles were found. Four studies met criteria, the following variables were analyzed: pelvic pain, dyspareunia and induration of the Pouch of Douglas after treatment and it was evaluated the presence of side effects during treatment: hot flushes, headache and BMD loss. There was no difference between the dienogest group and GnRH analogue group when it was evaluated maintenance of lower abdominal pain, dyspareunia, induration of the Pouch of Douglas after treatment and hot flushes during treatment. Besides those results, the dienogest group had a lower incidence of headache and less BMD loss. The treatment of endometriosis continues to be a challenge, even with new treatment options such as new drugs (dienogest) and surgical procedures. This meta-analysis provides evidence of the absence of dienogest inferiority compared with GnRH analogues with less BMD loss and less headache incidence.

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Condition tags

endometriosischronic_pelvic_paindysmenorrheadyspareuniainfertility

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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