Modification of endometrioma size during hormone therapy containing dienogest

Xholli, Anjeza; Filip, Gabriele; Previtera, Francesca; Cagnacci, Angelo

doi:10.1080/09513590.2019.1703942

Cited by 26 publications

(23 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The linear relation was observed between baseline volume and net change in volume. This finding was consistent with the finding in a study by Xholli et al 17 In this study there were three pregnancies (10%) in the follow up period after completion of 6 months treatment. Similarly, pregnancy after successful completion of treatment with aromatase inhibitor were also observed by Shippen et al; Verma et al; Seal et al and Abushahin et al 14,33,37,43 There are some limitations of the study.…”

Section: Discussionsupporting

confidence: 94%

Evaluation of the effect of aromatase inhibitor in reducing the size of endometrioma

Ansary¹,

Ishrat²,

Banu³

et al. 2021

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: Endometriosis is a chronic and progressive estrogen-dependent disorder that can result in substantial morbidity, including pelvic pain, multiple operations, and infertility. Endometriosis can be ovarian, peritoneal or deep infiltrative. Blocking estrogen production by inhibiting aromatization, aromatase inhibitor (letrozole) has been shown to reduce the size of endometrioma and endometriosis associated pain. Aim of the study was to evaluate the effect of aromatase inhibitor in reducing the size of endometrioma.Methods: A prospective non comparative observational study was conducted in the Department of Reproductive Endocrinology and Infertility of BSMMU on 30 women with ovarian endometrioma during the period of April 2019 to March 2020. Women were treated with aromatase inhibitor (letrozole) 2.5 mg, norethisterone 5 mg, calcium 1200 mg, and vitamin D 800 IU daily for 6 months. Transvaginal ultrasound was performed at baseline, 3 months and 6 months after treatment to assess the mean diameter and volume of endometriomas. Statistical analyses were carried out by using the Statistical Package for Social Sciences version 23.0.Results: More than 50% reduction in volume occurred in 90% of endometrioma. In one (3.3%) case endometrioma disappeared completely after 6 months. There was statistically significant reduction of size of endometrioma (estimated by mean diameter and volume) and pain. Volume decrease was linearly related to baseline endometrioma volume and inversely related to baseline body mass index (BMI). The side effects were mild and well tolerated by the patients.Conclusions: Treatment of ovarian endometrioma with aromatase inhibitor combined with progestin add-back for 6 months cause substantial reduction in size of endometrioma and associated pain.

show abstract

Section: Discussionsupporting

confidence: 94%

Evaluation of the effect of aromatase inhibitor in reducing the size of endometrioma

Ansary¹,

Ishrat²,

Banu³

et al. 2021

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…All these findings are consistent with the capability of dienogest treatment to control and reduce the activity of functional endometrium, including that displaced either within the myometrium [32] or outside the uterus [34].…”

Section: Discussionsupporting

confidence: 81%

Dienogest-based hormonal contraception induced changes in the ultrasound presentation of the uterus and menstrual pain

2021

Clinical and Experimental Obstetrics & Gynecology

View full text Add to dashboard Cite

In young women, combined hormonal contraceptives can ameliorate menstrual pain and reduce menstrual loss, but their efficacy in adenomyosis has not been proven. The aim of this study was to investigate whether ultrasound features of adenomyosis are modified by a combined hormonal contraceptive containing dienogest. Methods: Fifty-eight out of 173 premenopausal women consecutively attending our university hospital outpatient service for contraception were enrolled in this observational study. Women with menstrual pain or heavy menstrual bleeding underwent ultrasonography. An expert sonographer diagnosed or excluded adenomyosis and fibroids via morphological uterus sonographic assessment (MUSA). The intensity of menstrual pain was quantified by each patient on a visual analogue scale (VAS). A total of 38 women with and 20 without ultrasound features of adenomyosis received dienogest-based hormonal contraceptive and had a follow-up ultrasound after 6 months of treatment. Results: During treatment, uterine volume decreased by -13.1 ± 22.1% (p = 0.001) in women with adenomyosis features, while it tended to increase in controls. Hypoechoic striation of myometrium present in 95% of cases and myometrial cysts in 5% of cases, respectively, at baseline, had completely disappeared by 6 months. Asymmetry of uterine walls decreased, with the anterior/posterior wall ratio declining from 2.8 ± 0.8. to 1.9 ± 0.7 (p = 0.0001). Heterogeneous myometrial texture, globous uterine morphology, and junctional zone alteration remained unchanged. In women with baseline adenomyosis, VAS score for menstrual pain decreased by -4.0 ± 3.6 (p = 0.0001). During treatment, a VAS score for menstrual pain close to 0 was found in all women without adenomyosis. Days of menstrual flow decreased in women with (p = 0.0001) and without (p = 0.003) adenomyosis. Conclusions: Dienogest-based hormonal contraceptives improve the sonographic features of adenomyosis and improve symptoms. Prospective data are needed to confirm these findings.

show abstract

“…Endometriosis is a common chronic inflammatory disease characterized by ectopic endometrial tissue outside the uterine cavity [1][2][3]. Its prevalence is roughly 5-10% in the general female population but reaches 71-87% in women with pelvic pain [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…Endometriosis is a common chronic inflammatory disease characterized by ectopic endometrial tissue outside the uterine cavity [1,2,3]. Its prevalence is roughly 5-10 % in the general female population but reaches 71-87 % in women with pelvic pain [2,3]. Endometriosis can be characterized by superficial implants on the abdominal serous membrane or distant organs (e. g., pleura or pericardium) [3,4,5].…”

Section: Introductionmentioning

confidence: 99%

The Benefit of Transvaginal Elastography in Detecting Deep Endometriosis: A Feasibility Study

Xholli

Londero²,

Cavalli

et al. 2023

Ultraschall Med

Self Cite

View full text Add to dashboard Cite

Objectives: This study aimed to evaluate elastography features of deep infiltrating endometriosis (DIE), and to define whether this technique may discriminate lesions from surrounding non-endometriotic tissue. Methods: This was an exploratory observational study on women affected by DIE treated in a third-level academic hospital gynaecology outpatient facility between 2020 and 2021. Strain elastography (SE) was conducted via transvaginal probe. Tissue deformation of DIE and surrounding tissue was expressed as percentage tissue deformation or as subjective colour score (CS; from blue=stiff to red=soft, assigned numerical values from 0 to 3). Ratios of normal tissue/DIE were compared to ratio of normal tissue/stiffer normal tissue area. Results: Evaluations were performed on 46 DIE nodules and surrounding tissue of the uterosacral ligaments (n=21), parametrium (n=7), rectum (n=14), and recto-vaginal septum (n =4). Irrespective of location, DIE strain ratio (3.09, IQR 2.38–4.14 vs. 1.25, IQR 1.11–1.48; p<0.001) and CS ratio (4.62, IQR 3.83–6.94 vs. 1.13, IQR 1.06–1.29; p<0.001) was significantly higher than that of normal tissue. ROC AUC of CS ratio was higher than ROC AUC of strain ratio (99.76%, CI.95 99.26–100% vs. 91.35%, CI.95 85.23–97.47%; p=0.007), and best ROC threshold for CS ratio was 1.82, with a sensitivity of 97.83% (CI.95 93.48–100%) and a specificity of 100% (CI.95 100-100%). Conclusions: Both strain and CS ratios accurately distinguish DIE nodules at various locations. Applications of elastography in improving the diagnosis DIE, in distinguishing different DIE lesions and in monitoring DIE evolution can be envisioned and are worthy of further evaluation.

show abstract

Modification of endometrioma size during hormone therapy containing dienogest

Cited by 26 publications

References 34 publications

Evaluation of the effect of aromatase inhibitor in reducing the size of endometrioma

Evaluation of the effect of aromatase inhibitor in reducing the size of endometrioma

Dienogest-based hormonal contraception induced changes in the ultrasound presentation of the uterus and menstrual pain

The Benefit of Transvaginal Elastography in Detecting Deep Endometriosis: A Feasibility Study

Contact Info

Product

Resources

About