Dienogest and deep infiltrating endometriosis: The remission of symptoms is not related to endometriosis nodule remission
Open accessAbstract
Objective To evaluate the effectiveness of dienogest in controlling pain caused by deep infiltrating endometriosis (DIE), its influence on the quality of live (QoL) of women affected by the disease, and the effect of the drug on the volume of endometriotic lesions.Study design A prospective cohort study including 30 women with a sonographic diagnosis of DIE (intestinal and posterior fornix) treated with dienogest 2mg per day for 12 months. We evaluated the pain symptoms and the volume of the intestinal and posterior fornix lesions before and after 12 months of use of dienogest. To perform the statistical analysis, we used the Wilcoxon signed-rank test, and the relationship between the data was tested using the Spearman correlation coefficient.Results Women were on average 36.13±6.24years old. Pain symptoms most commonly reported were dyspareunia (83.3%), dysmenorrhea (73.3%), and pelvic pain (66.7%). After 12 months of treatment with dienogest, there was significant improvement of various symptoms (dyspareunia p=0.0093, dysmenorrhea p<0.0001; pelvic pain p=0.0007; and bowel pain p<0.0001), without a reduction in the volume of endometriotic nodules. There were significant improvements in the parameters that comprise the QoL (physical p<0.0001; p=0.0007 psychological) and the self-assessment of QoL (p=0.0069) and health (p=0.0001).Conclusion Dienogest is an effective medication to control symptoms of pain related to DIE, even without reducing the volume of DIE nodules.
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DNG appears to be effective in controlling pain caused by rectovaginal endometriosis, bladder endometriosis and DIE.
“DNG also appears to be effective in controlling pain caused by rectovaginal endometriosis [194], bladder endometriosis [195, 196] and DIE [197].”
From Hormonal treatments for endometriosis: The endocrine background (2022) · cites this paper as [197]
In a prospective cohort study including 30 women with a sonographic diagnosis of DIE treated with DNG for 12 months, the treatment was effective to control symptoms of pain related to DIE, improving QoL, even without reducing the volume of DIE nodules.
“In a prospective cohort study including 30 women with a sonographic diagnosis of DIE (intestinal and posterior fornix) treated with DNG for 12 months, the treatment was effective to control symptoms of pain related to DIE (dysmenorrhea, dyspareunia, dischezia), improving QoL, even without reducing the volume of DIE nodules [198].”
From Hormonal treatments for endometriosis: The endocrine background (2022) · cites this paper as [198]
Dienogest treatment for an extended period can alleviate symptoms but has no cytoreductive effect on DE lesions.
“dienogest treatment for an extended period could alleviate symptoms but has no cytoreductive effect on DE lesions (Leonardo-Pinto et al., 2017).”
From Progressively diminished estrogen signaling concordant with increased fibrosis in ectopic endometrium (2025) · cites this paper as Leonardo-Pinto et al., 2017
Dienogest for 12 months significantly decreased intestinal pain in women with rectovaginal and bowel endometriosis but did not significantly reduce bowel lesion size.
“Intestinal pain decreased significantly during the study period but, at odds with their previous experience (35), the authors did not observe a significant reduction in bowel lesions size.”
From Medical treatment in the management of deep endometriosis infiltrating the proximal rectum and sigmoid colon: a comprehensive literature review (2018) · cites this paper as Leonardo-Pinto et al. (14)
In a prospective case series of 30 women, dienogest 2 mg/day for 12 months significantly improved pain symptoms (dysmenorrhea, dyspareunia, chronic pelvic pain, bowel pain) and quality of life.
“Significant improvement of pain symptoms (dysm, dysp, CPP, bowel pain) and QoL.”
From Medical treatment in the management of deep endometriosis infiltrating the proximal rectum and sigmoid colon: a comprehensive literature review (2018) · cites this paper as [14]
In the same prospective case series of 30 women, there were no significant changes in volume size of endometriotic nodules.
“No significant changes in volume size of endometriotic nodules.”
From Medical treatment in the management of deep endometriosis infiltrating the proximal rectum and sigmoid colon: a comprehensive literature review (2018) · cites this paper as [14]
The reduction in lesion volume with estroprogestins or progestins is not predictable and not significant in the vast majority of cases.
“The reduction in lesion volume is not predictable and not significant in the vast majority of cases. Conflicting results have been observed [77,78,79,80,81,82,86,87,88].”
From Endometriosis and Medical Therapy: From Progestogens to Progesterone Resistance to GnRH Antagonists: A Review (2021) · cites this paper as [88]
In a prospective study of 30 patients with deep infiltrating endometriosis, after one year of DNG treatment there was significant improvement in all pain symptoms including deep dyspareunia, without reduction in volume of endometriotic lesions at transvaginal sonography.
“After one year of treatment there was a significant improvement in all pain symptoms, including deep dyspareunia, without a reduction in the volume of endometriotic lesions at transvaginal sonography.”
From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [37]
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The role of dienogest and other progestogens in the management of endometriosis-related pain
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- Authors
- Leonardo-Pinto, J. P., Benetti-Pinto, C. L., Cursino, K., & Yela, D. A.
- Affiliations
- Universidade Estadual de Campinas (UNICAMP) (BR)
- Corresponding author
- Yela, Daniela Angerame
- Venue
- European Journal of Obstetrics & Gynecology and Reproductive Biology
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 211
- Pages
- 108-111
- ISSN
- 0028-2243 (ISSN-L)
- 0301-2115
- OpenAlex
- W2587994610
- Cited by
- 72
- References
- 38
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2023: 9 · 2022: 8 · 2021: 8 · 2020: 17 · 2019: 4 · 2018: 14 · 2017: 3
- FWCI
- 12.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Obstetrics & Gynecology and Reproductive Biology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- dienogest, deep infiltrating endometriosis, dyspareunia, dysmenorrhea, pelvic pain, quality of life, symptom remission
- MeSH terms
- Adult, Constipation, Endometriosis, Female, Hormone Antagonists, Humans, Intestinal Diseases, Nandrolone, Pain Measurement, Prospective Studies, Quality of Life, Treatment Outcome, Pelvic Pain
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