Impact of dienogest therapy on CA125 levels, hormonal profile, and systemic inflammatory indices in endometriosis

Aims: The present study aims to evaluate the impact of dienogest therapy on CA125 levels, hormonal profile, and systemic inflammatory indices in patients with endometriosis, a chronic inflammatory disorder in which inflammation constitutes a fundamental component of the pathophysiology. Methods: This retrospective, pre–post analytical study included 150 female with endometriosis who received dienogest. Demographic and laboratory data were obtained from electronic medical records. Systemic inflammatory indices including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-to-monocyte ratio (NMR), plateletto-lymphocyte ratio (PLR), mean platelet volume (MPV), MPV-to-lymphocyte ratio (MPVLR), cancer antigen 125 (CA-125), Systemic Immune-inflammation Index (SII), Systemic Inflammation Response Index (SIRI), and pan-immune-inflammation value (PIV) were evaluated before and after treatment. Statistical analyses were performed using appropriate parametric and nonparametric tests, and correlation analyses were conducted. Results: Following dienogest therapy, statistically significant reductions were observed in CA125 levels (p=0.010) and PLR (p=0.028), along with decreases in leukocyte, and PCT levels. FSH levels showed a significant increase (p=0.001), whereas LH, estradiol, progesterone, TSH, FT3, and FT4 levels remained unchanged (p>0.05 for all). Significant increases were also noted in hemoglobin, hematocrit, MCV, and MCH values after treatment (p<0.05). No statistically significant differences were detected in NLR, MLR, NMR, MPVLR, SII, SIRI, or PIV. Correlation analyses demonstrated a positive association between CA 125 and PLR, as well as inverse correlations between CA125 and hematocrit. Conclusion: Dienogest therapy was associated with a reduction in CA125 levels and specific inflammatory markers, alongside improvements in certain hematological parameters in patients with endometriosis. These findings suggest a potential antiinflammatory benefit, indicating that dienogest may be involved in the modulation of systemic inflammatory burden. Furthermore, the preservation of endocrine homeostasis may support its favorable safety profile as an effective therapeutic option in the management of endometriosis.