The Long-Term Effect of Dienogest on Bone Mineral Density After Surgical Treatment of Endometrioma

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Three years of dienogest use post-endometrioma surgery significantly decreased bone mineral density, with no predictive factors for this reduction identified.

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This retrospective study evaluated changes in bone mineral density (BMD) over 3 years in 44 reproductive-aged women who received dienogest 2 mg/day following laparoscopic endometrioma surgery, with an additional analysis of predictive factors using BMD changes after 1 year in a larger set (160 women with decreased BMD). After 3 years, BMD significantly decreased at both the lumbar spine (−4.4%) and femur neck (−3.6%), with most lumbar spine loss occurring during the first year followed by a more gradual decline. The authors found no associated predictive factors for BMD reduction based on the first-year BMD change analysis, which is a key limitation in identifying who may be at higher risk. This paper is centrally about endometriosis — it examines long-term effects of postoperative dienogest on BMD after surgical treatment of endometrioma.

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Abstract

The aim of this study was to evaluate the changing pattern of bone mineral density (BMD) levels after 3 years of dienogest use post endometrioma surgery and investigate the possible predictive factors for BMD reduction. This retrospective study included 44 reproductive-aged women who took dienogest (2 mg/day) and followed up BMD for 3 years after laparoscopic endometrioma surgery from July 2013 to December 2018. In addition, to investigate the predictive factors in the group with decreased BMD, analysis was added for patients with decreased BMD after taking dienogest for 1 year post laparoscopic endometrioma surgery. After 3 years of treatment with dienogest, BMD of both the lumbar spine (- 4.4%) and femur neck (- 3.6%) decreased significantly compared to the baseline levels. Bone loss predominantly occurred during the first year of treatment in the lumbar spine (- 2.4%) and gradually decreased with time during the treatment period. The predictive factors for BMD reduction after dienogest use were evaluated based on a 1-year change in BMD levels of 160 women, but no associated factors were found. This study demonstrated that dienogest use for 3 years was associated with a significant and gradual decrease in BMD and no predictive factors for BMD reduction during the first year of treatment with dienogest were found. These results may be useful in counseling patients regarding long-term effects of dienogest use on reducing BMD levels so that appropriate preventive measures can be taken.
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Abstract

The aim of this study was to evaluate the changing pattern of bone mineral density (BMD) levels after 3 years of dienogest use post endometrioma surgery and investigate the possible predictive factors for BMD reduction. This retrospective study included 44 reproductive-aged women who took dienogest (2 mg/day) and followed up BMD for 3 years after laparoscopic endometrioma surgery from July 2013 to December 2018. In addition, to investigate the predictive factors in the group with decreased BMD, analysis was added for patients with decreased BMD after taking dienogest for 1 year post laparoscopic endometrioma surgery. After 3 years of treatment with dienogest, BMD of both the lumbar spine (− 4.4%) and femur neck (− 3.6%) decreased significantly compared to the baseline levels. Bone loss predominantly occurred during the first year of treatment in the lumbar spine (− 2.4%) and gradually decreased with time during the treatment period. The predictive factors for BMD reduction after dienogest use were evaluated based on a 1-year change in BMD levels of 160 women, but no associated factors were found. This study demonstrated that dienogest use for 3 years was associated with a significant and gradual decrease in BMD and no predictive factors for BMD reduction during the first year of treatment with dienogest were found. These results may be useful in counseling patients regarding long-term effects of dienogest use on reducing BMD levels so that appropriate preventive measures can be taken. Similar content being viewed by others Data Availability Not applicable.

References

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Cancer Res. 1976;36(7 PT 1):2297–301. Barbieri RL. Hormone treatment of endometriosis: the estrogen threshold hypothesis. Am J Obstet Gynecol. 1992;166(2):740–5. Gerlinger C, Faustmann T, Hassall JJ, Seitz C. Treatment of endometriosis in different ethnic populations: a meta-analysis of two clinical trials. BMC Womens Health. 2012;12:9. Author information Authors and Affiliations Contributions Conception and design: Hyun-Hye Lim and DooSeok Choi. Data collection: Sung Eun Kim and Hyun-Hye Lim. Analysis and interpretation: Sung Eun Kim and Dong-Yun Lee. Writing the article: Sung Eun Kim, Dong-Yun Lee, and DooSeok Choi. Corresponding author Ethics declarations Conflict of Interest The authors declare that they have no conflict of interest. Ethics Approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This retrospective study was granted approval by the Institutional Review Board on Samsung Medical Center (IRB approval number: 2019-07-145). Consent to Participate The requirement for required consent was waived due to the retrospective nature of this study. Consent for Publication Not applicable. Code Availability Not applicable. Additional information Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Kim, S.E., Lim, HH., Lee, DY. et al. The Long-Term Effect of Dienogest on Bone Mineral Density After Surgical Treatment of Endometrioma. Reprod. Sci. 28, 1556–1562 (2021). https://doi.org/10.1007/s43032-020-00453-7 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-020-00453-7

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Condition tags

endometriosisendometrioma

MeSH descriptors

Bone Density Endometriosis Nandrolone Adult Bone Density Endometriosis Female Humans Nandrolone Nandrolone Postoperative Complications Retrospective Studies

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