IMPACT OF RECURRENCE-PREVENTION PROGESTIN-BASED PHARMACOTHERAPY ON QUALITY OF LIFE IN PATIENTS WITH RECURRENT OVARIAN ENDOMETRIOMAS

Mykhailo Cherniak
In: Collection of scientific papers «ΛΌГOΣ» with Proceedings of the VIII International Scientific and Practical Conference «Theoretical and practical aspects of modern scientific research» (Seoul, South Korea; 14 August 2026) · 2026 · pp. 94–97 · doi:10.36074/logos-14.08.2026.019 · W7219696484
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This paper reviews the high recurrence rates of ovarian endometriomas after surgery and the associated risks of infertility and acute complications, highlighting the clinical challenge of preventing recurrence with progestin-based pharmacotherapy.

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This paper examines the impact of recurrence-prevention progestin-based pharmacotherapy on quality of life in patients with recurrent ovarian endometriomas. It highlights that while laparoscopy is a conservative treatment, repeated cystectomies damage healthy ovarian tissue and impair reproductive potential, leading to high recurrence rates ranging from 21.5% within two years to as high as 50% at five years. The text notes that large cystic masses pose risks of torsion or rupture requiring immediate surgical intervention, emphasizing the clinical challenge of managing these lesions long-term. This paper is centrally about endometriosis — specifically focusing on the management and recurrence prevention of ovarian endometriomas using progestin therapy.

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Abstract

Recurrent ovarian endometriomas remain a serious challenge in gynecological practice, given their range of adverse consequences for women’s health. The presence of endometriomas, and particularly their progressive enlargement, can lead to severe complications: large cystic masses carry a risk of ovarian torsion or cyst apoplexy (rupture), accompanied by an acute peritoneal syndrome that is life-threatening and requires immediate surgical intervention. Although laparoscopy is considered the most conservative treatment approach, study data indicate that repeated cystectomy procedures inevitably damage adjacenthealthy ovarian tissue, which, when the lesion is located on the ovary, significantly impairs a woman’s reproductive potential and increases the risk of infertility. According to various authors, the incidence of endometrioma recurrence increases progressively with longer postoperative follow-up, ranging from 21.5% within the first two years to 40–50% at 5 years, while other estimates report rates as high as 36% at 7–8 years after surgical treatment.
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IMPACT OF RECURRENCE-PREVENTION PROGESTIN-BASED PHARMACOTHERAPY ON QUALITY OF LIFE IN PATIENTS WITH RECURRENT OVARIAN ENDOMETRIOMAS DOI: https://doi.org/10.36074/logos-14.08.2026.019Abstract Recurrent ovarian endometriomas remain a serious challenge in gynecological practice, given their range of adverse consequences for women’s health. The presence of endometriomas, and particularly their progressive enlargement, can lead to severe complications: large cystic masses carry a risk of ovarian torsion or cyst apoplexy (rupture), accompanied by an acute peritoneal syndrome that is life-threatening and requires immediate surgical intervention. Although laparoscopy is considered the most conservative treatment approach, study data indicate that repeated cystectomy procedures inevitably damage adjacenthealthy ovarian tissue, which, when the lesion is located on the ovary, significantly impairs a woman’s reproductive potential and increases the risk of infertility. According to various authors, the incidence of endometrioma recurrence increases progressively with longer postoperative follow-up, ranging from 21.5% within the first two years to 40–50% at 5 years, while other estimates report rates as high as 36% at 7–8 years after surgical treatment.References Жилка, Н. Я., & Вороніна, К. І. (2025). Диференційований комплексний підхід до лікування та профілактики рецидивів у жінок з ендометріозом. Український медичний часопис, 3(169), 108–112. https://doi.org/10.32471/umj.1680-3051.265696 Фартушок, Т., & Козловська, Х. (2026). Збереження фертильності у жінок з ендометріозом. Grail of Science , (62), 1315 –1329. https://doi.org/10.36074/grail-of-science.20.02.2026.159 Amir, M., Ishrat, S., Nasrin, I., Halder, S., Rahman, F., & Hossain, M. R. Z. (2022). Letrozole versus dienogest in endometrioma recurrent after surgery: A randomized controlled trial. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 11(10), 2715–2722. https://doi.org/10.18203/2320-1770.ijrcog20222371 Becker, C. M., Bokor, A., Heikinheimo, O., Horne, A., Jansen, F. … & Vermeulen, N. (2022). ESHRE guideline: Endometriosis. Human Reproduction Open, 2022 (2), hoac009. https://doi.org/10.1093/hropen/hoac009 Caruso, S., Iraci, M., Cianci, S., Vitale, S. G., Fava, V., & Cianci, A. (2019). Effects of long-term treatment with dienogest on the quality of life and sexual function of women affected by endometriosis-associated pelvic pain. Journal of Pain Research, 12 , 2371 –2378. https://doi.org/10.2147/JPR.S207599 Del Forno, S., Cofano, M., Esposti, E. D., Manzara, F., Lenzi, J. … & Seracchioli, R. (2021). Long-term medical therapy after laparoscopic excision of ovarian endometriomas: Can we reduce and predict the risk of recurrence? Gynecologic and Obstetric Investigation, 86, 170–176. https://doi.org/10.1159/000514310 Kalaitzopoulos, D., Zografou, M., Nirgianakis, K., Daniilidis, A., Krentel, H., Eberhard, M., & Samartzis, N. (2023). Treatment after endometrioma recurrence: A narrative review. Minerva Obstetrics and Gynecology , 75(5), 449–459. https://doi.org/10.23736/S2724-606X.23.05249-1 Muzii, L., Di Tucci, C., Galati, G., Carbone, F., Palaia, I. … & Di Donato, V. (2023). The efficacy of dienogest in reducing disease and pain recurrence after endometriosis surgery: A systematic review and meta-analysis. Reproductive Sciences, 30 , 3135 –3143. https://doi.org/10.1007/s43032-023-01266-0 Szypłowska, M., Tarkowski, R., & Kułak, K. (2023). The impact of endometriosis on depressive and anxiety symptoms and quality of life: A systematic review. Frontiers in Public Health, 11, 1230303. https://doi.org/10.3389/fpubh.2023.1230303 Techatraisak, K., Hestiantoro, A., Soon, R., Banal-Silao, M. J., Kim, M. R. … & Lee, B. S. (2022). Impact of long-term dienogest therapy on quality of life in Asian women withendometriosis: The prospective non-interventional study ENVISIOeN. Reproductive Sciences, 29(4), 1157–1169. https://doi.org/10.1007/s43032-021-00787-w Zakhari, A., Edwards, D., Ryu, M., Matelski, J. J., Bougie, O., & Murji, A. (2020). Dienogest and the risk of endometriosis recurrence following surgery: A systematic review and meta-analysis. Journal of Minimally Invasive Gynecology, 27 (7), 1503 –1510. https://doi.org/10.1016/j.jmig.2020.05.007 Zhang, P., & Wang, G. (2023). Progesterone resistance in endometriosis: Current evidence and putative mechanisms. International Journal of Molecular Sciences, 24(8), 6992. https://doi.org/10.3390/ijms24086992 Downloads Published Issue Section License Copyright (c) 2026 Cherniak Mykhailo Mykhailovych This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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