Efficacy of dienogest in the treatment of symptomatic adenomyosis: a pilot study

Abstract

Adenomyosis is a common disorder in premenopausal women that causes dysmenorrhea, pelvic pain and menorrhagia. Considering that adenomyosis is an estrogen-dependent disease, the medical treatment is based on this hormone. Effective and well-tolerated medical treatments for symptomatic adenomyosis are needed. Dienogest, an oral progestin, has been extensively investigated in the treatment of endometriosis. In this report, we present the results on the efficacy and safety of dienogest in the treatment of symptomatic adenomyosis. Seventeen patients with symptomatic adenomyosis were included in this study, of which 15 continued dienogest for up to 24 weeks. Dienogest significantly reduced adenomyosis-associated pelvic pain as well as serum CA-125 and CA19-9 levels. It also demonstrated a modest suppression of estradiol (>50 pg/ mL), which is consistent with the findings of other reports. During treatment, five patients experienced worsening anemia because of metrorrhagia, which is the most frequent adverse effect associated with dienogest. This report suggests that dienogest is an effective and well-tolerated therapy for symptomatic adenomyosis.

Chinese abstract

子宫内膜异位症在绝经前期妇女中是一种常见疾病，引起痛经、盆腔痛和月经过多。考虑到子宫内膜异位症是一种雌激素依赖性疾病，因此治疗以雌激素为基础。有症状的子宫内膜异位症需要有效的且患者耐受良好的治疗。地诺孕素，一种口服孕激素，在内异症治疗中已被广泛研究。本文介绍了采用地诺孕素治疗有症状的子宫内膜异位症的有效性和安全性结果。17位有症状的内异症患者参与了本实验，其中有15位持续服用地诺孕素至24周。地诺孕素显著降低了内异症相关的盆腔痛以及血清CA-125和CA19-9水平。同时，地诺孕素也显示了对雌二醇在一定程度上的抑制（>50pg/ml）,这与其他论文中的研究结果相一致。治疗过程中，5名患者因月经过多出现了不断恶化的贫血，这是地诺孕素最常见的不良反应。本文认为地诺孕素对有症状的子宫内膜异位症的治疗是有效的且患者的耐受良好。

• Adenomyosis
• dienogest
• pelvic pain

Acknowledgements

The authors would like to thank Enago (www.enago.jp) for the English language review.