Dienogest and deep infiltrating endometriosis: The remission of symptoms is not related to endometriosis nodule remission

Abstract

Dienogest is an effective medication to control symptoms of pain related to DIE, even without reducing the volume of DIE nodules.

Daily Vaginal Application of Dienogest (Visanne©) for 3 Months in Symptomatic Deeply Infiltrating Rectovaginal Endometriosis: A Possible New Treatment Approach?

“…The rectovaginal examination was also significantly less painful after 3 months of dienogest (VAS examination 9 versus VAS examination 4). These findings are in accordance with our own experience and experience reported by others: before the size of the node declines, symptoms initially improve [ 14 ]. Despite the higher local dosage of dienogest, a reduction in the size of rectovaginal endometriosis nodes can probably only be observed clinically later on, since rectovaginal endometriosis always represents as adenomyofibromatous lesion [ 15 ], treatment-related remission of which takes time [ 16 ].…”

Daily Vaginal Application of Dienogest (Visanne©) for 3 Months in Symptomatic Deeply Infiltrating Rectovaginal Endometriosis: A Possible New Treatment Approach?

“…The rectovaginal examination was also significantly less painful after 3 months of dienogest (VAS examination 9 versus VAS examination 4). These findings are in accordance with our own experience and experience reported by others: before the size of the node declines, symptoms initially improve [ 14 ]. Despite the higher local dosage of dienogest, a reduction in the size of rectovaginal endometriosis nodes can probably only be observed clinically later on, since rectovaginal endometriosis always represents as adenomyofibromatous lesion [ 15 ], treatment-related remission of which takes time [ 16 ].…”

Deeply Infiltrating Endometriosis (DIE) No More: Dienogest as a Game Changer in Rectovaginal Endometriosis

“…It has also shown to effect reduction and even complete remission of the endometriotic lesions after nine months of therapy, avoiding the need for repeat surgical intervention. This finding is congruent with existing evidence that shows the improvement of symptoms before the reduction in size of the lesion [ 2 ]. Further, Wu et al's recent meta-analysis involving 256 patients illustrated significant improvement in the relief of dysmenorrhoea, dyspareunia, and pelvic pain, besides rectosigmoid lesion size after Dienogest monotherapy in targeting DIE [ 3 ].…”

Long-Term Administration of Dienogest for the Treatment of Pain and Intestinal Symptoms in Patients with Rectosigmoid Endometriosis

“…In our study, one of most common adverse effects related to DNG treatment was irregular uterine bleeding, consistent with previous reports [28,32]. As expected, its frequency and amount decreased as treatment progressed (from 16.9% of patients at 6 months to 6% at 36 months).…”

Daily Vaginal Application of Dienogest (Visanne©) for 3 Months in Symptomatic Deeply Infiltrating Rectovaginal Endometriosis: A Possible New Treatment Approach?

“…The rectovaginal examination was also significantly less painful after 3 months of dienogest (VAS examination 9 versus VAS examination 4). These findings are in accordance with our own experience and experience reported by others: before the size of the node declines, symptoms initially improve [ 14 ]. Despite the higher local dosage of dienogest, a reduction in the size of rectovaginal endometriosis nodes can probably only be observed clinically later on, since rectovaginal endometriosis always represents as adenomyofibromatous lesion [ 15 ], treatment-related remission of which takes time [ 16 ].…”

Deeply Infiltrating Endometriosis (DIE) No More: Dienogest as a Game Changer in Rectovaginal Endometriosis

“…It has also shown to effect reduction and even complete remission of the endometriotic lesions after nine months of therapy, avoiding the need for repeat surgical intervention. This finding is congruent with existing evidence that shows the improvement of symptoms before the reduction in size of the lesion [ 2 ]. Further, Wu et al's recent meta-analysis involving 256 patients illustrated significant improvement in the relief of dysmenorrhoea, dyspareunia, and pelvic pain, besides rectosigmoid lesion size after Dienogest monotherapy in targeting DIE [ 3 ].…”

Long-Term Administration of Dienogest for the Treatment of Pain and Intestinal Symptoms in Patients with Rectosigmoid Endometriosis

“…In our study, one of most common adverse effects related to DNG treatment was irregular uterine bleeding, consistent with previous reports [28,32]. As expected, its frequency and amount decreased as treatment progressed (from 16.9% of patients at 6 months to 6% at 36 months).…”

Daily Vaginal Application of Dienogest (Visanne©) for 3 Months in Symptomatic Deeply Infiltrating Rectovaginal Endometriosis: A Possible New Treatment Approach?

“…The rectovaginal examination was also significantly less painful after 3 months of dienogest (VAS examination 9 versus VAS examination 4). These findings are in accordance with our own experience and experience reported by others: before the size of the node declines, symptoms initially improve [ 14 ]. Despite the higher local dosage of dienogest, a reduction in the size of rectovaginal endometriosis nodes can probably only be observed clinically later on, since rectovaginal endometriosis always represents as adenomyofibromatous lesion [ 15 ], treatment-related remission of which takes time [ 16 ].…”

Deeply Infiltrating Endometriosis (DIE) No More: Dienogest as a Game Changer in Rectovaginal Endometriosis

“…It has also shown to effect reduction and even complete remission of the endometriotic lesions after nine months of therapy, avoiding the need for repeat surgical intervention. This finding is congruent with existing evidence that shows the improvement of symptoms before the reduction in size of the lesion [ 2 ]. Further, Wu et al's recent meta-analysis involving 256 patients illustrated significant improvement in the relief of dysmenorrhoea, dyspareunia, and pelvic pain, besides rectosigmoid lesion size after Dienogest monotherapy in targeting DIE [ 3 ].…”

Long-Term Administration of Dienogest for the Treatment of Pain and Intestinal Symptoms in Patients with Rectosigmoid Endometriosis

“…In our study, one of most common adverse effects related to DNG treatment was irregular uterine bleeding, consistent with previous reports [28,32]. As expected, its frequency and amount decreased as treatment progressed (from 16.9% of patients at 6 months to 6% at 36 months).…”