Dienogest Versus Medroxyprogesterone Acetate for Control of Menstrual Pain in Chinese Women with Endometriosis Abstract
YYI WONG, MHM LEE
Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Jordan, Hong Kong
Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Jordan, Hong Kong
Objective:This study aimed to compare dienogest with medroxyprogesterone acetate for management of
endometriosis in terms of menstrual pain, quality of life, adverse effects, tolerability, and overall satisfaction.
Methods:This was a cross-sectional, observational study of 60 Chinese women with endometriosis aged 18 to
55 years who were receiving active treatment for ≥6 months with either medroxyprogesterone acetate (150 mg
intramuscularly every 3 months) [n=30] or dienogest (2 mg oral daily) [n=30, since 2013]. A questionnaire together
with a written consent was posted in July 2017 to patients for completion. The questionnaire comprised 11 questions
about pain (n=4), quality of life (n=3), adverse effects and tolerability (n=3), and overall satisfaction with treatment
(n=1). Pain symptoms included menstrual pain, chronic pelvic pain, dyspareunia, and dyschezia. Quality of life
assessment was based on questions derived from the SF-36 questionnaire and included daily living, work life, and
social life. An 11-point rating scale was used.
Results: 25 patients from the dienogest group and 26 patients from the medroxyprogesterone acetate groups
returned the questionnaire, with an overall response rate of 83%. Before treatment, the two groups were comparable
in terms of baseline characteristics, pain symptoms, and quality of life. After treatment, the mean score for menstrual
pain in the dienogest and medroxyprogesterone acetate groups reduced from 5.5 and 4.88 to 1.8 and 3.65,
respectively, with the dienogest group achieving a greater absolute reduction (6.6 vs. 4.69, p=0.044). Satisfaction
score was higher with dienogest than medroxyprogesterone acetate (8.2 vs. 6.81, p=0.024).
Conclusion: Dienogest is more effective than medroxyprogesterone acetate in treating symptomatic endometriosis
and control of menstrual pain, with higher tolerability and satisfaction rate.
Hong Kong J Gynaecol Obstet Midwifery 2018; 18(2):91–7