Clinical Efficacy of Dienogest for Symptomatic Adenomyosis

Background: This study was conducted to assess whether medical treatment with dienogest (DNG) is effective in women with symptomatic adenomyosis. Methods: This single-center, retrospective study included patients with symptomatic adenomyosis treated with oral DNG 2 mg daily. We evaluated the clinical symptoms, uterine volume, and serum CA-125 levels in these patients along with adverse events at baseline and after 3, 6, 12, 18, and 24 months of treatment, respectively. Results: A total of 102 patients were analyzed. Among women with dysmenorrhea, 79.5% reported improvement in dysmenorrhea, and the mean time to improvement in dysmenorrhea was 7.18 months. Improvement in heavy menstrual bleeding was observed in 88.3% of patients, with a mean time to improvement in heavy menstrual bleeding of 5.44 months. We could see that the uterine volume decreased significantly after 18 months of treatment. Serum CA-125 levels declined significantly from 3 months onward and remained reduced through 24 months. More than half of the patients (55.8%) continued DNG without complications, whereas 31.3% discontinued treatment or switched to alternative therapies. Conclusions: DNG effectively improved clinical symptoms and reduced uterine volume and serum CA-125 levels without serious adverse events in patients with symptomatic adenomyosis.