Evaluation of endometrial thickness and pain symptoms in women with deep endometriosis using dienogest: retrospective cohort

ABSTRACT

BACKGROUND AND OBJECTIVES  Endometriosis is a chronic, inflammatory and estrogen-dependent disease. The most common symptoms include dysmenorrhea, dyspareunia, chronic pelvic pain and infertility. The study’s objective is to evaluate the effect of dienogest on endometrial thickness and correlate it with pain symptoms in women with deep endometriosis.

METHODS  Retrospective cohort study with 104 women diagnosed with deep endometriosis from a tertiary hospital from 2018 to 2022. The variables of sociodemographic characteristics of women, pain symptoms at the beginning of treatment with dienogest and after one year, in addition to the endometrial thickness measured by ultrasound were evaluated at the beginning of treatment and after one year of using dienogest.

RESULTS  The average age of the women was 36.0±6.3 years, the majority were white (81.7%), nulliparous (44.2%), with a partner (68.2%) and with a body mass index of 27.6± 5.4 kg/m². Among the study participants, 41.3% had undergone previous surgeries and only 15.3% had another comorbidity. There was better control of dysmenorrhea (p<0.001) and dysuria (p=0.031) with the use of dienogest. The greater the endometrial thickness, the greater the dysmenorrhea (p=0.04). There was no correlation between endometrial thickness and other pain symptoms.

CONCLUSION  The use of dienogest for 12 months reduced dysmenorrhea and dysuria but did not reduce other pain complaints. Endometrial thickness is directly related to dysmenorrhea.

Keywords:
Dysmenorrhea; Pelvic pain; Endometriosis

HIGHLIGHTS

The effectiveness of dienogest in the treatment of pain of deep endometriosis

Endometrial thickness is directly related to dysmenorrhea

There was no correlation between endometrial thickness and other pain symptoms

GRAPHICAL ABSTRACT