Quality of life and clinical factors in women with endometriosis, the role of dienogest vs EE/dienogest over time: a single-center study

Antonio Maiorana, Pietro Alfano, Antonella Mercurio, Salvatore Marcantonio, Gabriella Minneci, Domenico Incandela, Palma Audino
Archives of gynecology and obstetrics · 2023 · vol. 307(5) , pp. 1503–1512 · doi:10.1007/s00404-023-06942-9 · PMID:36738318 · W4319216484
article OA: hybrid CC0 ⤵ 6 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that longer duration of untreated endometriosis correlated with worse quality of life and that both dienogest and ethinylestradiol/dienogest improved symptoms and quality of life over 18 months.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This single-center observational study recruited 64 women with surgically or clinically diagnosed endometriosis and evaluated how psychological variables, endometriosis-associated pain (VAS), health-related quality of life (SF-36, EHP-30), and sexual satisfaction relate to duration untreated endometriosis (DUE) at baseline and at an 18-month follow-up. Participants took either dienogest 2 mg daily (DNG) or dienogest/ethinylestradiol 0.03 mg daily (EE/DNG), with outcomes including SF-36 physical/mental component summary scores, EHP-30 domains, and an Index of Sexual Satisfaction, and analyses adjusted for some timing variability at follow-up. Longer DUE correlated with worse physical and overall HRQoL at baseline and follow-up, and pain measures showed negative correlations with physical and mental HRQoL domains; over time, dysmenorrhea and general pain decreased and multiple HRQoL and well-being domains improved regardless of treatment type, with a significant time-by-treatment interaction for dysmenorrhea and DNG showing a greater effect than EE/DNG on dyspareunia reduction over time. The main limitation explicitly noted by the study design is that it excluded women with missing data and provides only a single follow-up timepoint from a non-randomized, single-center cohort. This paper is centrally about endometriosis—assessing how DUE and pain relate to quality of life and how dienogest versus dienogest/ethinylestradiol affects symptoms and HRQoL over 18 months.

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Abstract

PURPOSE: The aims of this observational study were: to assess the relationship between psychological variables, pain, Duration Untreated Endometriosis (DUE) in a sample of women with Endometriosis; and to assess the effect of dienogest 2 mg/daily (DNG) and dienogest/ethinylestradiol 0.03 mg/daily (EE/DNG) on Symptoms, QoL, HRQoL, pain and sexual satisfaction, over time. METHODS: 64 women constituted the study group; (56%) took DNG and (44%) took EE/DNG. VAS, SF-36, EHP-30 and ISS were used to assess endometriosis-associated pelvic pain, QoL, HRQoL and sexual satisfaction, respectively. The study included one follow-up at 18 months. RESULTS: At T0, a longer period of DUE was related both to worst HRQoL and Physical QoL. At T1, a correlation was found between longer DUE and worst HRQoL. At T0, a negative correlation was found between VAS and PCS and between VAS and EHP-30. At T1, the same above correlation was found between VAS and PCS/MCS and VAS and EHP-30 scale. There was a correlation between ISS and VAS. ANOVA showed a reduction in dysmenorrhea, in general pain level and an improvement in emotional wellbeing, relationship with medical profession, and PCS over time, regardless to type of treatment. Moreover, a significant time × treatment group interaction for dysmenorrhea was found. CONCLUSION: DUE and pain are important variables related to psychological aspects of women with endometriosis. Treatment with both DNG and EE/DNG may have positive effects on the QoL, HRQoL and symptoms. Moreover, DNG seems to have a greater effect than EE/DNG on dyspareunia reduction over time.

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Outcome instruments

EHP-30 VAS-pain

Condition tags

mesh:D004412mesh:D004715endometriosisdysmenorrheadyspareunia

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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References (36)

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