Maintenance therapy with dienogest following gonadotropin-releasing hormone agonist treatment for endometriosis-associated pelvic pain

Jo Kitawaki, Kitawaki J, Izumi Kusuki, Kusuki I, Yamanaka K, Kaoruko Yamanaka, Izumi Suganuma, Suganuma I
European journal of obstetrics, gynecology, and reproductive biology · 2011 · vol. 157(2) , pp. 212–216 · doi:10.1016/j.ejogrb.2011.03.012 · PMID:21474232 · W1969971130
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This study evaluated the efficacy of dienogest maintenance therapy after GnRH agonist treatment for endometriosis-associated pelvic pain.

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Abstract

ObjectiveTo examine whether long-term administration of dienogest following gonadotropin-releasing hormone agonist (GnRH-a) therapy would prolong the relief of pelvic pain while reducing the amount of irregular uterine bleeding.Study designThis was a prospective, non-randomized clinical trial. Among the patients suffering from chronic pelvic pain associated with recurrent endometriosis, Group G (n=38) received GnRH-a for 4-6 months and then dienogest (1 mg/day) for 12 months. The dose of dienogest was increased to 1.5 or 2 mg/day when a patient had uncontrollable uterine bleeding {n=15 (39%)}. Group D (n=33) received only dienogest (2 mg/day) for 12 months. Pelvic pain was assessed using a visual analog scale (VAS). Uterine bleeding was semi-quantified using a pictorial blood loss assessment chart (PBAC).ResultsIn Group G, GnRH-a significantly reduced the VAS score for pelvic pain, and alleviation was maintained during the 12-month therapy with dienogest. There was no significant difference in pain reduction between Group G and Group D. The PBAC score during the first 6 months on dienogest was significantly smaller in Group G than in Group D.ConclusionTreatment with a GnRH-a followed by long-term dienogest therapy maintains the relief of endometriosis-associated pelvic pain achieved with GnRH-a therapy for at least 12 months. This regimen reduces the amount of irregular uterine bleeding that often occurs during the early phase of dienogest therapy.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Buserelin Endometriosis Gonadotropin-Releasing Hormone Hormone Antagonists Nandrolone Pelvic Pain Pelvic Pain Adult Buserelin Dose-Response Relationship, Drug Drug Therapy, Combination Endometriosis Female Gonadotropin-Releasing Hormone Hormone Antagonists Humans Middle Aged Nandrolone Nandrolone Pelvic Pain

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Cited by (50)

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