Dydrogesterone and Endometriosis

Abstract

The results are reported of the administration of dydrogesterone, 5 mg twice daily, to 49 patients with endometriosis. All but five patients were symptom-free after nine months of therapy. Most subjective symptoms had disappeared within four to eight weeks; dyspareunia usually took longer. In 30 out of 32 patients who had a culdoscopy after one or two treatment courses, a 'cure' of endometriosis was confirmed. Ten out of nineteen infertile patients became pregnant following treatment. The only side-effects were transient mastalgia and dizziness in two patients. No amenorrhoea or other disturbances of the menstrual cycle were reported.

Dydrogesterone in the treatment of endometriosis: evidence mapping and meta-analysis

“…One cohort study [ 33 ] was identified that compared dydrogesterone with no treatment after surgery (with 69 participants). The remaining 5 studies [ 16 , 19 , 21 , 23 , 34 ] (with 231 participants) were single-arm studies that investigated dydrogesterone without comparisons.…”

“…A total of 137 citations were excluded after screening of the title and abstract. Subsequently, 124 articles were excluded following a full-text review, leaving 19 articles eligible for qualitative synthesis [12,16,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. The study screening process and reasons for exclusion at the full-text screening stage are presented in Fig.…”

“…In all, 19 studies [12,16,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] were included. Nine RCTs were identified that compared dydrogesterone with a different dosage of dydrogesterone or placebo (1 study [20] with 62 participants), gestrinone (7 studies [22,24,25,27,28,30,32] with 693 participants), [20] or traditional Chinese medicine and acupuncture therapy (1 study [ 12 ] with 64 participants).…”

“…The proposed mechanism underlying the pharmacological action of progestogens involves the initial decidualization of endometrial tissue and eventual atrophy. Dydrogesterone causes atrophy of ectopic endometrium without suppressing the normal endometrium and simultaneously inhibits the development of new endometriotic lesions [ 16 ]. Furthermore, it does not inhibit ovulation and regular menstruation and does not induce weight gain and edema [ 15 ].…”

Pelvic Endometriosis: Etiology and Pathology

“…Progestins, such as medroxyprogesterone acetate, when used continuously, also suppress gonadotropin secretion and have been used in treating endometriosis. 88,89 The endometrium is initially progestationalized but, without continuous estrogen support, the endometrial tissue becomes atrophic. This is attributed to the fact that estrogen is required to induce progesterone receptors, and without receptors the progestins cannot bind, reducing trophic hormonal support of the endometrium.…”