CGRP neuropeptide levels in patients with endometriosis-related pain treated with dienogest: a comparative study

Shahla Chaichian, Ziba Dehghan Firoozabadi, Samaneh Rokhgireh, Kobra Tahermanesh, Abolfazl Mehdizadeh Kashi, Azam Govahi, Sara Minaeian, Mehdi Mehdizadeh, Marziyeh Ajdary
BMC women's health · 2024 · vol. 24(1) , pp. 257 · doi:10.1186/s12905-024-03095-y · PMID:38658933 · PMC11040845 · W4395081499
article OA: gold CC0 ⤵ 3 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Endometriosis patients exhibited elevated serum CGRP levels and pain, both of which significantly decreased after six months of dienogest treatment.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This comparative study evaluated whether dienogest (DNG), a hormonal therapy for endometriosis-related pain, changes serum levels of the pain-associated neuropeptide calcitonin gene-related peptide (CGRP) and pelvic pain in women aged 18–45 with histologically confirmed endometriosis and baseline pain score >5. Participants received 2 mg/day oral DNG for six months, with serum CGRP measured by ELISA before and after treatment (during the proliferative phase) and pain assessed using a visual analog scale (VAS); a control group of 15 healthy fertile women was included for baseline comparison. The endometriosis group had higher CGRP serum levels than controls, and after six months of DNG CGRP levels and VAS pain scores both decreased significantly versus pre-treatment values; the paper also notes that many screened participants were excluded/refused DNG due to side effects, which may limit generalizability. This paper is centrally about endometriosis — it directly measures CGRP and pain outcomes in endometriosis-related pain patients treated with dienogest.

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Abstract

BACKGROUND AND OBJECTIVE: Endometriosis (EM) involves the peripheral nervous system and causes chronic pain. Sensory nerves innervating endometriotic lesions contribute to chronic pain and influence the growth phenotype by releasing neurotrophic factors and interacting with nearby immune cells. Calcitonin gene-related peptide (CGRP), a pain-signaling neurotransmitter, has a significant role. This study examines the effect of Dienogest (DNG), a hormone therapy used for managing EM -related pain, on serum CGRP levels in EM patients. MATERIALS AND METHODS: The Visual Analog Scale (VAS) assessed pain in diagnosed EM. INDIVIDUALS: Serum samples were obtained to measure CGRP concentration. Participants received a 2 mg/day oral dose of DNG for six months as prescribed treatment. Additional serum samples were collected after this period to measure CGRP levels. RESULTS: In the EM group, 6.7%, 33.3%, and 20% had ovarian EM, ovarian plus uterosacral, and ovarian plus bladder, respectively. The EM group showed higher CGRP serum levels than the control group (80.53 ± 16.13 vs. 58.55 ± 6.93, P < 0.0001). Still, after drug administration, CGRP serum levels significantly decreased compared to pre-treatment levels (69.66 ± 11.53 vs. 80.53 ± 16.13, P < 0.05). The EM group showed higher pain compared to the control group (7.93 ± 1.58 vs. 0.13 ± 0.35, P < 0.0001), but after drug administration, pain significantly decreased compared to pre-treatment levels (1.00 ± 2.00 vs. 7.93 ± 1.58, P < 0.05). CONCLUSION: DNG administration reduces pain and serum CGRP levels in EM patients, offering the potential for innovative treatments and tailored options. Understanding neurotransmitter roles and drug effects can aid in discovering more effective modulators for these pathways.

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Outcome instruments

VAS-pain

Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide Calcitonin Gene-Related Peptide

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