Comparison of dienogest versus combined oral contraceptive pills in the treatment of women with adenomyosis: A randomized clinical trial

Ahmed Hassanin, Ahmed I Hassanin, Ahmed A Youssef, Asmaa M Yousef, Asmaa Yousef, Mohammed K Ali
International Journal of Gynecology & Obstetrics · 2021 · vol. 154(2) , pp. 263–269 · doi:10.1002/ijgo.13600 · PMID:33454995 · W3121945076
article OA: closed CC0 ⤵ 25 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This randomized trial found dienogest more effectively reduced adenomyosis pain and uterine volume than combined oral contraceptives over six months, despite a higher rate of side effects.

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Abstract

OBJECTIVE: To compare the efficacy and safety of dienogest with combined oral contraceptives (COCs) for treating adenomyosis-associated symptoms. METHODS: This was a randomized clinical trial including women with symptomatic adenomyosis conducted from March 1, 2019 to August 1, 2020 at Assiut Woman's Health Hospital, Egypt. Participants were randomly assigned to the dienogest group or COCs group. The primary outcome was the level of adenomyosis-associated pain from before to 6 months after treatment measured by a visual analog scale (VAS). Changes in the uterine bleeding pattern, uterine volume, and uterine artery blood flow were also reported. RESULTS: The VAS score of pain was significantly decreased in both groups; however, the decreased rate was more pronounced in the dienogest group (3.21 ± 1.18) in comparison with the COCs group (4.92 ± 1.22). Bleeding pattern was improved greatly; uterine volume and uterine artery blood flow decreased significantly in the dienogest group. However, women in the dienogest group reported a higher rate of side effects. CONCLUSION: Dienogest and COCs are effective in treating adenomyosis-associated symptoms after 6 months of use but dienogest is more effective. The decrease in uterine volume and uterine artery blood flow may be the cause of the treatment effect. Dienogest carries a higher risk of side effects. CLINICAL TRIAL: gov: NCT03890042.

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Outcome instruments

VAS-pain

Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Contraceptives, Oral, Combined Nandrolone Adenomyosis Adult Contraceptives, Oral, Combined Egypt Female Humans Nandrolone Nandrolone Pain Measurement Uterine Hemorrhage Uterine Hemorrhage

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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