Comparative Efficacy of Dienogest and Cabergoline in Pain Relief and Size Reduction of Ovarian Endometriomas: A Prospective Study

Dr. Raj Sekhar Sarkar, Santu Guin, Prof. (Dr.) Madhurima Chattopadhyay
2025 · doi:10.5281/zenodo.17942761 · W7115582077
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This prospective study compared dienogest and cabergoline in 50 women with ovarian endometriomas, finding that dienogest reduced cyst size more effectively while cabergoline showed slightly higher pain score reductions.

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This prospective study compared the efficacy of dienogest and cabergoline in treating ovarian endometriomas among 50 women experiencing pelvic pain. Participants were randomly assigned to receive either dienogest daily or cabergoline twice weekly for three months, with outcomes measuring cyst size reduction and pain score changes. The results showed that dienogest achieved significantly greater shrinkage of the endometrioma diameter, while cabergoline led to a slightly higher, though statistically non-significant, reduction in pain scores. Both treatments were well-tolerated, but the authors note that larger and longer-term studies are required to validate these preliminary findings. This paper is centrally about endometriosis — specifically the medical management of ovarian endometriomas using hormonal and dopamine agonist therapies.

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Abstract

ABSTRACT: Endometriosis‍‌‍‍‌‍‌‍‍‌ is a condition in which the growth of endometrial tissue occurs outside its typical location (most frequently the ovaries, where endometriomas form). This disease is the main reason for chronic pelvic pain and infertility in women of reproductive age. In this prospective comparative study, 50 women with ultrasound-detected ovarian endometriomas and pelvic pain were enrolled. They were randomly assigned to receive cabergoline 0.5 mg twice a week or dienogest 2 mg once a day for three months. The primary outcomes were changes in endometrioma size and pain scores. After the treatment, dienogest reduced the mean cyst diameter to a greater extent (around 19.7% compared to 8.77% with cabergoline), while cabergoline resulted in a slightly higher average reduction in visual analog scale pain scores (73% compared to 65% with dienogest), but this difference was not statistically significant. Both treatment regimens were generally well tolerated, with only mild and transient adverse effects reported. The results indicate that dienogest could be the drug of choice if the main therapeutic goal is to shrink the endometrioma, whereas cabergoline might be the drug of choice if pain relief and fertility preservation are prioritized. Therefore, larger and longer-term studies are needed to verify these ‍‌‍‍‌‍‌‍‍‌observations.
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Comparative Efficacy of Dienogest and Cabergoline in Pain Relief and Size Reduction of Ovarian Endometriomas: A Prospective Study Authors/Creators - 1. Department of Obstetrics and Gynaecology, Murshidabad Medical College and Hospital, Berhampore, West Bengal, India - 2. Department of EIE, Techno Main Salt Lake, Kolkata, West Bengal, India - 3. Department of AEIE, Heritage Institute of Technology, Kolkata, West Bengal, India Description ABSTRACT: Endometriosis is a condition in which the growth of endometrial tissue occurs outside its typical location (most frequently the ovaries, where endometriomas form). This disease is the main reason for chronic pelvic pain and infertility in women of reproductive age. In this prospective comparative study, 50 women with ultrasound-detected ovarian endometriomas and pelvic pain were enrolled. They were randomly assigned to receive cabergoline 0.5 mg twice a week or dienogest 2 mg once a day for three months. The primary outcomes were changes in endometrioma size and pain scores. After the treatment, dienogest reduced the mean cyst diameter to a greater extent (around 19.7% compared to 8.77% with cabergoline), while cabergoline resulted in a slightly higher average reduction in visual analog scale pain scores (73% compared to 65% with dienogest), but this difference was not statistically significant. Both treatment regimens were generally well tolerated, with only mild and transient adverse effects reported. The results indicate that dienogest could be the drug of choice if the main therapeutic goal is to shrink the endometrioma, whereas cabergoline might be the drug of choice if pain relief and fertility preservation are prioritized. Therefore, larger and longer-term studies are needed to verify these observations. Files 06Rajar.pdf Files (362.3 kB) | Name | Size | Download all | |---|---|---| | md5:38b20f622d6a911b022542cbe6e1bd8a | 362.3 kB | Preview Download | Additional details Dates - Available - 2025-12-15

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endometriosisendometriomachronic_pelvic_paininfertility

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