Short-term safety of dienogest on bone mineral density in Iranian women with endometriosis: A cross-sectional study

Ziba Dehghan Firoozabadi, Roya Derakhshan, Shahla Chaichian, Babak Sabet, Neda Hashemi, Samaneh Rokhgireh
In: Journal of Endometriosis and Pelvic Pain Disorders · 2026 · doi:10.1177/22840265251366379 · W7130834574
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This study found that 24 weeks of dienogest treatment in Iranian women with endometriosis significantly improved pain but showed no substantial adverse effect on overall bone mineral density, except for a minor reduction at L1.

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Abstract

Background: Dienogest (DNG) is a fourth-generation progestin used frequently for medical treatment of endometriosis. dienogest has been known as an effective treatment in alleviating pain, preventing recurrence, and enhancing the quality of life in patients. Considering the contradictory results regarding the side effects of DNG, such as the risk of decreasing bone mineral density, physiologic disorder, menometroraghy, and its effects in the treatment of endometriosis, this study was conducted to assess the efficacy and side effects of DNG 2 mg daily for 24 weeks in Iranian women with endometriosis. Methods: Before and 24 weeks after starting treatment with DNG, lumbar and pelvic bone mineral density (BMD) was measured. Changes in the severity of dysmenorrhea and dyspareunia and side effects were recorded using a visual analog scale. Results: The change in the investigated variables before and after the intervention was compared using chi-square and paired t -test. The mean age of the patients was 35.42 ± 4.76 years. Following the intervention, Dysmenorrhea and dyspareunia were significantly decreased ( p < 0.001). Total pelvic and vertebra BMD did not change substantially after the intervention, except for L1, which was significantly reduced after treatment (0.37 ± 0.96–0.22 ± 0.89; p = 0.01). Conclusion: The results of this study suggested that 24 weeks of treatment with DNG had no significant adverse effect on BMD. On the other hand, the use of DNG in endometriosis patients was associated with improvement in dysmenorrhea and dyspareunia scale.
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endometriosisdysmenorrheadyspareunia

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