Skip to main content

Advertisement

SpringerLink
Log in

Dienogest in the treatment of endometriosis: systematic review

  • Review
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Endometriosis is a prevalent disease that affects 5–15 % of women of reproductive age. The aim of this study is to assess the effect of dienogest in the treatment of endometriosis.

Methods

The search was applied to electronic databases PubMed, Cochrane, EMBASE and Lilacs until September 2014, in a public tertiary hospital. We performed a systematic literature search of randomized trials comparing dienogest to other medical therapies in the treatment of endometriosis, as well as their references list, using the keywords “dienogest” and “endometriosis” by two independent authors. The data extraction were performed by two authors using predefined data fields. Nine randomized trials were included. Dienogest 2 mg/day was superior to placebo in reducing pelvic pain (27.4 versus 15.1 mm, P < 0.0001), with similar results to buserelin, leuprorelin, leuprolide acetate and triptorelin, in controlling symptoms associated with endometriosis. Dienogest 2 mg/day was effective in reducing endometriotic lesions (11.4 ± 1.71–3.6 ± 0.95, P < 0.001). The extended therapy with dienogest 2 mg/day also showed an improvement in pelvic pain after 24–52 weeks (−22.5 ± 32.1 and −28.4 ± 29.9 mm, respectively) with tolerable side effects.

Conclusion

Dienogest should be considered as an alternative for controlling symptoms related to endometriosis. Nevertheless, in this systematic review, no studies were found comparing dienogest with first-line therapy, such as progestins and estrogen–progestogen combinations, which are proved to be effective in the treatment of endometriosis, are less expensive, and also can be used for contraception.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Halis G, Mechsner S, Ebert AD (2010) The diagnosis and treatment of deep infiltrating endometriosis. Dtsch Arztebl Int 107(25):446–455 (Quiz 456)

    PubMed Central  PubMed  Google Scholar 

  2. Bellelis P, Dias JA Jr, Podgaec S et al (2010) Aspectos epidemiológicos e clínicos da endometriose pélvica-uma série de casos (Epidemiological and clinical aspects of pelvic endometriosis—a case series). Rev Assoc Med Bras 56(4):467–471

    Article  PubMed  Google Scholar 

  3. Berbel BT, Podgaec S, Abrao MS (2008) Análise da associação entre o quadro clínico referido pelas pacientes portadoras de endometriose e o local de acometimento da doença (Analysis of the association between symptoms referred by patients with endometriosis and the site of the disease). Rev Med (São Paulo) 87(3):195–200

    Article  Google Scholar 

  4. Podgaec S, Rizzo LV, Fernandes LF et al (2012) CD4(+) CD25(high) Foxp3(+) cells increased in the peritoneal fluid of patients with endometriosis. Am J Reprod Immunol 68(4):301–308

    Article  CAS  PubMed  Google Scholar 

  5. Vercellini P, Crosignani P, Somigliana E et al (2011) Waiting for Godot’: a commonsense approach to the medical treatment of endometriosis. Hum Reprod 26(1):3–13

    Article  PubMed  Google Scholar 

  6. Goncalves MO, Podgaec S, Dias JA Jr, Gonzalez M, Abrao MS (2010) Transvaginal ultrasonography with bowel preparation is able to predict the number of lesions and rectosigmoid layers affected in cases of deep endometriosis, defining surgical strategy. Hum Reprod 25(3):665–671

    Article  PubMed  Google Scholar 

  7. Vercellini P, Eskenazi B, Consonni D et al (2011) Oral contraceptives and risk of endometriosis: a systematic review and meta-analysis. Hum Reprod Update 17(2):159–170

    Article  CAS  PubMed  Google Scholar 

  8. Olive DL, Pritts EA (2001) Treatment of endometriosis. N Engl J Med 345(4):266–275

    Article  CAS  PubMed  Google Scholar 

  9. Petta CA, Ferriani RA, Abrao MS et al (2005) Randomized clinical trial of a levonorgestrel-releasing intrauterine system and a depot GnRH analogue for the treatment of chronic pelvic pain in women with endometriosis. Hum Reprod 20(7):1993–1998

    Article  CAS  PubMed  Google Scholar 

  10. Crosignani P, Olive D, Bergqvist A, Luciano A (2006) Advances in the management of endometriosis: an update for clinicians. Hum Reprod Update 12(2):179–189

    Article  CAS  PubMed  Google Scholar 

  11. Sitruk-Ware R, Nath A (2010) The use of newer progestins for contraception. Contraception 82(5):410–417

    Article  CAS  PubMed  Google Scholar 

  12. Köhler G, Faustmann TA, Gerlinger C, Seitz C, Mueck AO (2010) A dose-ranging study to determine the efficacy and safety of 1, 2, and 4 mg of dienogest daily for endometriosis. Int J Gynaecol Obstet 108(1):21–25

    Article  PubMed  Google Scholar 

  13. Harada T, Momoeda M, Taketani Y et al (2009) Dienogest is as effective as intranasal buserelin acetate for the relief of pain symptoms associated with endometriosis–a randomized, double-blind, multicenter, controlled trial. Fertil Steril 91(3):675–681

    Article  CAS  PubMed  Google Scholar 

  14. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700

    Article  PubMed Central  PubMed  Google Scholar 

  15. Revised American Society for Reproductive Medicine classification of endometriosis. Fertil Steril. 1997;67(5):817–21

  16. Kamiński K, Fiegler P, Marr J, Moore C (2001) Treatment of endometriosis with dienogest: preliminary report. Ginekol Pol 72(5):299–304

    PubMed  Google Scholar 

  17. Seitz C, Gerlinger C, Faustmann T et al (2009) Safety of dienogest in the long-term treatment of endometriosis: a one-year, open-label, follow-up study. Fertil Steril 92(3):107

    Article  Google Scholar 

  18. Strowitzki T, Faustmann T, Gerlinger C, Seitz C (2010) Dienogest in the treatment of endometriosis-associated pelvic pain: a 12-week, randomized, double-blind, placebo-controlled study. Eur J Obstet Gynecol Reprod Biol 151(2):193–198

    Article  CAS  PubMed  Google Scholar 

  19. Momoeda M, Taketani Y (2007) A randomized, double-blind, multicenter, parallel, dose-response study of dienogest in patients with endometriosis (in Japanese). J Pharmacol Ther 35:769–783

    Google Scholar 

  20. Cosson M, Querleu D, Donnez J et al (2002) Dienogest is as effective as triptorelin in the treatment of endometriosis after laparoscopic surgery: results of a prospective, multicenter, randomized study. Fertil Steril 77(4):684–692

    Article  PubMed  Google Scholar 

  21. Strowitzki T, Marr J, Gerlinger C, Faustmann T, Seitz C (2010) Dienogest is as effective as leuprolide acetate in treating the painful symptoms of endometriosis: a 24-week, randomized, multicentre, open-label trial. Hum Reprod 25(3):633–641

    Article  CAS  PubMed  Google Scholar 

  22. Strowitzki T, Marr J, Gerlinger C, Faustmann T, Seitz C (2012) Detailed analysis of a randomized, multicenter, comparative trial of dienogest versus leuprolide acetate in endometriosis. Int J Gynaecol Obstet 117(3):228–233

    Article  CAS  PubMed  Google Scholar 

  23. Petraglia F, Hornung D, Seitz C et al (2012) Reduced pelvic pain in women with endometriosis: efficacy of long-term dienogest treatment. Arch Gynecol Obstet 285(1):167–173

    Article  PubMed Central  PubMed  Google Scholar 

  24. Momoeda M, Harada T, Terakawa N et al (2009) Long-term use of dienogest for the treatment of endometriosis. J Obstet Gynaecol Res 35(6):1069–1076

    Article  CAS  PubMed  Google Scholar 

  25. Johnson NP (2013) Hummelshoj L; World Endometriosis Society Montpellier Consortium. Consensus on current management of endometriosis. Hum Reprod 28(6):1552–1568

    Article  PubMed  Google Scholar 

  26. Vercellini P, Crosignani P, Somigliana E, Viganò P, Frattaruolo MP, Fedele L (2011) Waiting for Godot: a commonsense approach to the medical treatment of endometriosis. Hum Reprod 26:3–13

    Article  PubMed  Google Scholar 

  27. Crosignani PG, Luciano A, Ray A, Bergqvist A (2006) Subcutaneous depot medroxyprogesterone acetate versus leuprolide acetate in the treatment of endometriosis-associated pain. Hum Reprod 21:248–256

    Article  CAS  PubMed  Google Scholar 

  28. Taylor RN, Hummelshoj L, Stratton P (2012) Vercellini P Pain and endometriosis: etiology, impact, and therapeutics. Middle East Fertil Soc J 17(4):221–225

    Article  PubMed Central  PubMed  Google Scholar 

  29. Brown J, Pan A, Hart RJ (2010) Gonadotrophin-releasing hormone analogues for pain associated with endometriosis. Cochrane Database Syst Rev 12:CD008475

    PubMed  Google Scholar 

  30. Brown J, Kives S, Akhtar M (2012) Progestagens and anti-progestagens for pain associated with endometriosis. Cochrane Database Syst Rev 3:CD002122

    PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Endometriosis Clinic, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Av. Dr Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, CEP, 05403-010, Brazil

    Marina de Paula Andres, Livia Alves Lopes & Sergio Podgaec

  2. Gynecologic Clinic, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil

    Edmund Chada Baracat

Authors
  1. Marina de Paula Andres
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Livia Alves Lopes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Edmund Chada Baracat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sergio Podgaec
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marina de Paula Andres.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Andres, M.d., Lopes, L.A., Baracat, E.C. et al. Dienogest in the treatment of endometriosis: systematic review. Arch Gynecol Obstet 292, 523–529 (2015). https://doi.org/10.1007/s00404-015-3681-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-015-3681-6

Keywords

Search

Navigation