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Comparison of dienogest versus combined oral contraceptive pills in the treatment of women with adenomyosis: A randomized clinical trial
Author(s) -
Hassanin Ahmed I.,
Youssef Ahmed A.,
Yousef Asmaa M.,
Ali Mohammed K.
Publication year - 2021
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13600
Subject(s) - dienogest , medicine , adenomyosis , uterine artery , pelvic pain , gynecology , randomized controlled trial , visual analogue scale , endometriosis , obstetrics , urology , surgery , pregnancy , gestation , biology , genetics
Objective To compare the efficacy and safety of dienogest with combined oral contraceptives (COCs) for treating adenomyosis‐associated symptoms. Methods This was a randomized clinical trial including women with symptomatic adenomyosis conducted from March 1, 2019 to August 1, 2020 at Assiut Woman's Health Hospital, Egypt. Participants were randomly assigned to the dienogest group or COCs group. The primary outcome was the level of adenomyosis‐associated pain from before to 6 months after treatment measured by a visual analog scale (VAS). Changes in the uterine bleeding pattern, uterine volume, and uterine artery blood flow were also reported. Results The VAS score of pain was significantly decreased in both groups; however, the decreased rate was more pronounced in the dienogest group (3.21 ± 1.18) in comparison with the COCs group (4.92 ± 1.22). Bleeding pattern was improved greatly; uterine volume and uterine artery blood flow decreased significantly in the dienogest group. However, women in the dienogest group reported a higher rate of side effects. Conclusion Dienogest and COCs are effective in treating adenomyosis‐associated symptoms after 6 months of use but dienogest is more effective. The decrease in uterine volume and uterine artery blood flow may be the cause of the treatment effect. Dienogest carries a higher risk of side effects. Clinical trial.gov: NCT03890042.