A Study on the Systematic Review & Meta-Analysis of the Effectiveness of Dienogest Therapy against the Combined Oral Contraceptive Pill \non Patient with Endometriosis Surgery Cases: \nA Study of VAS Scores for Dysmenorrhea, Dyschesia and Dysparenia.

Introduction: DIE is a common disease of women of childbearing age. After laparoscopy, combined oral Contraceptive Pill (COCP) and Dienogest have been used for endometriosis. This study aims to evaluate the effect of dienogest compared with the combined oral contraceptive pill on the pain scores of dysmenorrhea, dyspareunia, and dyschezia in patients with deep infiltrating endometriosis. \nMethod: The data was taken from 1363 samples of 9 research literature, divided into 2 groups: the dienogest group and the group receiving the combination of contraceptive pills. The main symptoms assessed were using a visual analog scale (VAS) for dysmenorrhea, dyspareunia, and dyschezia \nResult: 7 studies showed significant differences in dysmenorrhea scores between the Dienogest and CCOCP groups, except for 2 articles. For Dyspareunia Score there were 6 studies with the dyspareunia score in the Dienogest group being lower than in the combination of contraceptive pill group. In contrast, in 3 other articles, the dyspareunia score in the Dienogest group was higher than in the combination of contraceptive pill group. There were no significant differences among the study groups in terms of patient demographics. Assessment of the risk of bias in the meta-analysis of the therapeutic effectiveness of the Egger regression test showed non-significant results. This shows that there is no potential for publication bias (t=1.111; df=7.00; p=0.303) \nConclusion: These 9 studies firmly stated that dienogest was the effective treatment in a double-blind, placebo-controlled condition and showed that dienogest was effective fand was well tolerated as a treatment for pain symptomsKeywords: Dienogest, CCOCP, Deep Infiltrating Endometriosis.