The synthetic progestogen dienogest has been closely studied in recent years for its therapeutic efficacy in endometriosis. Despite its benign nature, this disease is a serious problem due to its widespread prevalence and negative impact on various aspects of quality of life. This systematic review analyzed the effectiveness of dienogest treatment using various scales and questionnaires to assess the dynamics of endometriosis symptoms (dysmenorrhea, chronic pelvic pain, deep dyspareunia), as well as intestinal and urological symptoms associated with endometriosis. The results of assessing the quality of life and patient satisfaction with dienogest treatment are presented. The endpoints for the efficacy of dienogest therapy included changes in laboratory (CA-125 and anti-Müllerian hormone levels) and instrumental (pelvic and mammary gland ultrasound, pelvic magnetic resonance imaging) examinations. We analyzed the effects of dienogest therapy as preoperative preparation to improve prognosis and postoperative treatment to prevent recurrence of the disease. To determine the safety profile, all adverse effects were recorded, including those related to the mammary glands. Bone mineral density, incidence of abnormal uterine bleeding, and incidence of treatment discontinuation due to adverse reactions were also assessed. Thus, the review covered the main efficacy and safety endpoints of dienogest therapy in women with different endometriosis phenotypes. Based on the results of this systematic analysis, it can be concluded that dienogest therapy for endometriosis is effective and safe. However, a personalized approach is required for selection of optimal therapy.
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Yarmolinskaya et al. (2025) studied this question.
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