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Efficacy and Safety of Long-Term Use of Dienogest in Women With Ovarian Endometrioma

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Abstract

Dienogest (DNG) is a progestin with highly selective progesterone activity and minimal androgenic activity and is helpful in reducing endometriosis-related pain. This study assessed the long-term efficacy and safety and recurrence rate of endometrioma with DNG use beyond 12 months of treatment. A retrospective cohort study was conducted with data collected from 7 university-affiliated hospitals and included a total of 514 women with ovarian endometrioma. All patients received 2 mg of oral DNG daily for at least 48 weeks postoperatively. During continuation of DNG, the recurrence rate of ovarian endometrioma on ultrasound, adverse events, changes in menstrual pattern, and pain score (visual analogue scale) were analyzed. The average period of DNG administration in this study was 72.2 + 5.2 weeks (range: 48-164). The recurrence rate of endometrioma was 1.8% (9 of 514), and the median duration to recurrence was 58 weeks (range: 24-76). Pain was described as overall improved by 82.2% of patients; 61.6% stated the pain was “improved” and 20.6% reported “much improved.” The mean VAS score was 4.9 at baseline and significantly decreased to 2.68, 2.2, 1.6, and 2.6 at 12, 24, 48, and 96 weeks. Amenorrhea rate was 58.3% in the first 12 weeks and increased to 86.4% at 72 weeks. Prolonged daily administration of 2 mg DNG followed by surgery was associated with a lower recurrence rate of ovarian endometrioma and a reduced pain score and symptoms.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, South Korea

    Sa Ra Lee MD, PhD

  2. Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, South Korea

    Kyong Wook Yi MD, PhD

  3. Department of Obstetrics and Gynecology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Jae Yen Song MD, PhD

  4. Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Seok Kyo Seo MD, PhD

  5. Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea

    Seok Kyo Seo MD, PhD & SiHyun Cho MD, PhD

  6. Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea

    Dong-Yun Lee MD, PhD

  7. Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea

    SiHyun Cho MD, PhD

  8. Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Sung Hoon Kim MD, PhD

Authors
  1. Sa Ra Lee MD, PhD
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  2. Kyong Wook Yi MD, PhD
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  3. Jae Yen Song MD, PhD
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  4. Seok Kyo Seo MD, PhD
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  5. Dong-Yun Lee MD, PhD
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  7. Sung Hoon Kim MD, PhD
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Corresponding authors

Correspondence to Dong-Yun Lee MD, PhD or SiHyun Cho MD, PhD.

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Lee, S.R., Yi, K.W., Song, J.Y. et al. Efficacy and Safety of Long-Term Use of Dienogest in Women With Ovarian Endometrioma. Reprod. Sci. 25, 341–346 (2018). https://doi.org/10.1177/1933719117725820

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  • DOI: https://doi.org/10.1177/1933719117725820

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