Targeted therapy for pelvic pain associated with endometriosis. Assessment of quality of life and sexual function

Objective. To study the efficacy of dienogest 2 mg in the treatment of female patients with pelvic pain associated with endometriosis in terms of improving the quality of life and sexual function. Patients and methods. The study group included 54 female patients with confirmed diagnosis of genital endometriosis (adenomyosis, infiltrating endometriosis, ovarian endometrial cysts). Dienogest 2 mg once daily was prescribed to all patients; 38 patients received non-steroidal anti-inflammatory drugs and constituted the comparison group. The visual analogue scale was used to assess pelvic pain, dysmenorrhea, and dyspareunia in patients with endometriosis. The 36-Item Short Form Survey (SF-36), the Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale (FSDS) were used to assess the quality of life, sexual function, and sexual distress, respectively. The study contained two consecutive follow-ups after 3 and 6 months. All patients included in the study refused the proposed surgical treatment. Results. A slight decrease in chronic pelvic pain, dysmenorrhea, and dyspareunia was observed in the study group after 3 months (p < 0.05) with a progressive decrease in pain intensity by 6 months of dienogest administration (p < 0.001). The qualityof-life assessment showed a similar tendency: improvements were significant in several categories after 3 months (p < 0.05) and in all categories by 6 months (p < 0.001). The FSFI score had no changes after 3 months of follow-up (p with no statistical significance) but improved between 3 and 6 months (p < 0.001). The same was observed regarding the FSDS scale (p < 0.001). No changes were seen in the comparison group. Conclusion. Administration of dienogest 2 mg once daily in women with endometriosis-associated pelvic pain significantly reduces pain syndrome while positively affecting the quality of life and sexual function. Key words: dyspareunia, endometriosis, chronic pelvic pain, dienogest, quality of life, sexual activity