Main conclusion
Real-world data show two truths at once: dienogest may markedly reduce endometriosis pain, while tolerability may limit long-term use. Effectiveness and adverse effects need to be assessed together.
What the study did
The questionnaire study included 146 patients. Complete resolution of dysmenorrhea was reported by 55 of 123 women who had the symptom at baseline, or 44.7%. Mean self-rated quality of life increased from 4.4 to 5.5 points. Every participant reported at least one adverse event, and 40.4% discontinued therapy. Fatigue, reduced libido, and mood disturbance were the most frequently reported problems.
Key limitations
This was a cross-sectional observational study based on patient report. Pretreatment symptoms were recalled retrospectively. The absence of a control group and prospective standardized measurement increases recall and selection bias. The study describes patient experience but cannot compare dienogest with alternative treatments.
What can be said to patients
Follow-up should assess not only pain, but also mood, libido, fatigue, bleeding, and quality of life. Discontinuing a poorly tolerated treatment is not non-adherence; it is information needed for shared selection of another strategy.
Source
Journal of Gynecology Obstetrics and Human Reproduction, 2026. DOI: https://doi.org/10.1016/j.jogoh.2026.103272
PubMed: https://pubmed.ncbi.nlm.nih.gov/42692407/
Educational material; it does not replace individual medical advice.