Long-term treatment of endometriosis with dienogest for up to five years

Hiroaki Takagi, Jinichi Sakamoto, Toshiyuki Sasagawa
In: Clinical and Experimental Obstetrics & Gynecology · 2019 · vol. 46(3) , pp. 398–402 · doi:10.12891/ceog4720.2019 · W3042794863
article OA: bronze CC0 ⤵ 7 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

Long-term dienogest treatment for up to five years effectively reduced endometriosis pain and endometrioma size, with stable adenomyosis size and no adverse effects on bone mineral density.

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

This retrospective study collected data from 21 patients diagnosed with endometriosis and/or adenomyosis who received dienogest 2 mg/day for more than 12 months, with 10 patients followed for up to 60 months, assessing pelvic pain by VAS, ovarian endometrioma size by ultrasonography (RECIST categories), uterine adenomyosis size, bleeding patterns, and multiple blood and biochemical parameters including bone mineral density by DXA. Dienogest reduced dysmenorrhea and pelvic pain to low VAS scores and was effective for ovarian endometrioma regression in most endometrioma cases, while uterine adenomyosis size remained essentially unchanged; irregular bleeding was the most frequent adverse effect (>90%), with some patients discontinuing due to heavy bleeding. Over 60 months, major laboratory parameters did not show indicative changes, CA125 decreased in those with elevated baseline levels, estradiol remained within a described therapeutic window with slight FSH changes, and bone mineral density decreased slightly at 12 months but was nearly back to pretreatment levels by 60 months. The authors’ key limitation is the small sample size and retrospective design, and they report that only a subset had hormonal and BMD follow-up to 60 months. This paper is centrally about endometriosis — it evaluates long-term (up to five years) pain control, endometrioma size changes, and safety of dienogest therapy in patients with endometriosis (with some adenomyosis patients included).

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Abstract

Purpose of Investigation: Dienogest is marketed in Japan as the first time in the world for novel treatment of endometriosis. This paper details the retrospective investigation how effective long-term use of dienogest is for the treatment of endometriosis. Materials and Methods: Data on 21 patients of diagnosed as endometriosis/adenomyosis and treated with dienogest for more than 12 months (ten patients with 60-month period) were collected. Results: Dienogest was effective in reducing pain and size of ovarian endometrioma, while the size of adenomyosis remained the same size as before treatment. The most frequent adverse effects were irregular bleeding. There was no reduction in bone mineral density after 60 months while plasma estradiol was maintained at a slightly lower level. Clinical parameters for did not change during a 60-month period. Conclusions: These results show that dienogest is safe to use for at least five years and is an effective treatment for endometriosis for long periods.

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Condition tags

endometriosisadenomyosisendometrioma

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