Dienogest Versus Medroxyprogesterone Acetate for Control of Menstrual Pain in Chinese Women with Endometriosis Abstract

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
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