Tanha Fatemeh Davari, Rasti Azam, Pakniat Hamideh, Setudeh Shohreh Salimi
Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Non-Communicable Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
Int J Reprod Biomed. 2025 Jan 31;22(12):995-1002. doi: 10.18502/ijrm.v22i12.18065. eCollection 2024 Dec.
Endometriosis is a chronic inflammatory condition associated with debilitating chronic pelvic pain that affects women's quality of life. Several drugs have been used to reduce pain and psychological distress associated with this disease. Currently, gonadotropin-releasing hormone (GnRH) agonists and dienogest are the most widely used medical therapies for endometriosis.
This study aimed to investigate the efficacy of dienogest and GnRH agonists in improving pelvic pain after laparoscopic surgery for endometriosis.
In this randomized clinical trial study, 104 women with endometriosis who were referred to the Department of Reproductive Medicine of Yas hospital, Tehran, Iran, between April 2022 and March 2023 were studied. After laparoscopic surgery, individuals were randomly assigned into 2 groups (n = 52/each): the dienogest-administered group and the GnRH agonist-administered group. Participants were followed up at 3 months and pelvic pain was measured using the visual analog scale. Pelvic pain and adverse effects of drugs were compared between the groups.
Pelvic pain significantly improved in both treatment groups (p 0.0001). No significant difference was observed in hot flashes and joint pain between the dienogest and GnRH agonist groups. However, a significant difference was found in vaginal dryness (p = 0.03) and decreased libido (p = 0.02). GnRH agonists and dienogest reduced irregular vaginal bleeding.
Our results suggested that the effect of GnRH agonists and dienogest in improving pelvic pain for endometriosis is the same after a 3-month treatment period. However, these 2 drugs caused different adverse effects.
子宫内膜异位症是一种慢性炎症性疾病，伴有使人衰弱的慢性盆腔疼痛，影响女性的生活质量。已经使用了几种药物来减轻与这种疾病相关的疼痛和心理困扰。目前，促性腺激素释放激素（GnRH）激动剂和地诺孕素是治疗子宫内膜异位症最广泛使用的药物疗法。
本研究旨在探讨地诺孕素和GnRH激动剂在改善子宫内膜异位症腹腔镜手术后盆腔疼痛方面的疗效。
在这项随机临床试验研究中，对2022年4月至2023年3月期间转诊至伊朗德黑兰亚斯医院生殖医学科的104例子宫内膜异位症女性进行了研究。腹腔镜手术后，将个体随机分为两组（每组n = 52）：地诺孕素给药组和GnRH激动剂给药组。在3个月时对参与者进行随访，并使用视觉模拟量表测量盆腔疼痛。比较两组之间的盆腔疼痛和药物不良反应。
两个治疗组的盆腔疼痛均有显著改善（p < 0.0001）。地诺孕素组和GnRH激动剂组在潮热和关节疼痛方面未观察到显著差异。然而，在阴道干燥（p = 0.03）和性欲减退（p = 0.02）方面发现了显著差异。GnRH激动剂和地诺孕素减少了不规则阴道出血。
我们的结果表明，在3个月的治疗期后，GnRH激动剂和地诺孕素在改善子宫内膜异位症盆腔疼痛方面的效果相同。然而，这两种药物引起的不良反应不同。
