A Cohort Study of the Efficacy of the Dienogest and the Gonadotropin-Releasing Hormone Agonist in Women with Adenomyosis

Purpose: To study the efficacy and safety of the dienogest and the Gonadotropin-Releasing Hormone agonist (GnRH-a) in symptomatic females with uterine adenomyosis. Methods: A total of 127 patients with adenomyosis with a chief complaint of dysmenorrhea were recruited. The first group received 2mg of Dienogest (DNG) daily, whereas the second group received Goserelin Acetate (GS) (3.6mg/4 weeks) for 12 weeks. Outpatient follow-up was undertaken after 12 weeks. Results: Among 127 women, 56/63 (87.5%) patients completed the treatment in the DNG group, whereas 62/64 (96.9%) patients completed the treatment in the GS group. A significant decrease in dysmenorrhea symptoms as measured by the Visual Analog Scale (VAS) and Carcinoma Antigen125 (CA125) after 12 weeks of treatment was observed in both groups (P<0.001). The hemoglobin of anemic patients did not significantly improve after 12 weeks of treatment (P=0.21) and the uterine volume slightly increased without statistical significance (P=0.10) in the DNG group. Simultaneously, the hemoglobin of anemic patients significantly improved (P<0.001) and the uterine volume significantly decreased (P<0.001) in the GS group. Conclusions: Dienogest effectively alleviates the symptoms of dysmenorrhea in patients with adenomyosis, but it cannot improve the anemia or reduce the size of the uterus. GnRH-a is more effective in improving anemia and reducing the uterine volume in patients with adenomyosis.