Effect of vaginal gestrinone in Pentravan® on endometriosis patients using Mirena®: A preliminary report

This open observational study evaluated 20 women with deep endometriosis-related severe pain who were using the levonorgestrel intrauterine system Mirena® and continued to have symptoms, testing whether adding low-dose vaginal gestrinone in Pentravan® plus oral Pinus pinaster extract and resveratrol would improve pain and bleeding. Group A (n=14) started the combination 3–6 months after Mirena® insertion due to inadequate response, while Group B (n=6) began the combination at the time of Mirena® insertion; aromatase expression in eutopic endometrium was also assessed by immunohistochemistry in all Group A patients before and after 2 months, with pain measured by visual analog scale. Mirena® alone produced a modest significant pain reduction in Group A but did not induce amenorrhea and was associated with breakthrough bleeding and flare-ups; after adding the combination, dysmenorrhea pain scores dropped further and became pain-free by the second month, with Group B reaching similar pain scores after one month. The paper’s main limitation is its small, nonrandomized open design, and it does not provide long-term outcomes; relevance to endometriosis: this paper is centrally about endometriosis—vaginal low-dose gestrinone with antioxidants and its effect on deep endometriosis-related pain in patients using Mirena®.

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