Comparative Study of 0.5 mg Dienogest Tablets (1 mg/Day) and Continuous Low-Dose Estrogen/Progestin for Dysmenorrhea: A Retrospective Analysis—Influence of Bleeding-Related Factors Such as Endometrial Polyps, Uterine Fibroids, and Adenomyosis

Background/Objectives: Dienogest 0.5 mg tablets (DNG0.5) taken twice daily (1 mg/day) are more effective than cyclic low-dose estrogen/progestin/combined oral contraceptive (LEP/COC) in ameliorating dysmenorrhea pain and are recommended for dysmenorrhea treatment in Japan. However, their efficacy ha...

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Main Author: Haruko Yokosuka
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Endocrines
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Online Access:https://www.mdpi.com/2673-396X/6/1/12
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author Haruko Yokosuka
author_facet Haruko Yokosuka
author_sort Haruko Yokosuka
collection DOAJ
description Background/Objectives: Dienogest 0.5 mg tablets (DNG0.5) taken twice daily (1 mg/day) are more effective than cyclic low-dose estrogen/progestin/combined oral contraceptive (LEP/COC) in ameliorating dysmenorrhea pain and are recommended for dysmenorrhea treatment in Japan. However, their efficacy has not been directly compared with continuous LEP/COC regimens. Here, we evaluated the effectiveness of DNG0.5 compared to Yazflex<sup>®</sup> (YZF), a continuous LEP, in treating dysmenorrhea. Methods: The efficacy of DNG0.5 in treating dysmenorrhea was compared retrospectively with that of Yazflex, the longest continuously administered LEP/COC available in Japan. Results: The improvement rates of dysmenorrhea scores at 3 and 6 months post-treatment were 59.1% and 66.4% in the LEP group (<i>n</i> = 113) and 88.1% and 96.4% in the DNG0.5 group (<i>n</i> = 125), respectively. The complete resolution rate of dysmenorrhea at 6 months was 88.0% in the DNG0.5 group and 23.9% in the LEP group. These findings indicate that DNG0.5 was significantly more effective than LEP (<i>p</i> < 0.01). DNG0.5 exerted an early pain-suppressing effect, which continued to increase thereafter. Furthermore, the presence of endometrial polyps, uterine fibroids, or adenomyosis, which are risk factors for irregular genital bleeding, was examined. Among these, endometrial polyps were particularly more likely to cause bleeding and potentially reduce the effect of DNG0.5; however, even with these three risk factors, DNG0.5 was more effective than LEP in reducing pain. Conclusions: Dienogest was more effective than LEP in managing dysmenorrhea, even at a dosage of 0.5 mg twice daily. However, factors affecting irregular vaginal bleeding should be considered when prescribing DNG0.5.
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spelling doaj-art-d1d24647202e44da9bf5f4c7545941602025-08-20T03:43:36ZengMDPI AGEndocrines2673-396X2025-03-01611210.3390/endocrines6010012Comparative Study of 0.5 mg Dienogest Tablets (1 mg/Day) and Continuous Low-Dose Estrogen/Progestin for Dysmenorrhea: A Retrospective Analysis—Influence of Bleeding-Related Factors Such as Endometrial Polyps, Uterine Fibroids, and AdenomyosisHaruko Yokosuka0Department of Gynecology, Yokosuka Internal Medicine and Pediatrics/Haruko Women’s Clinic, 6-47-21 Kaneda Higashi, Kisarazu-shi 292-0009, Chiba, JapanBackground/Objectives: Dienogest 0.5 mg tablets (DNG0.5) taken twice daily (1 mg/day) are more effective than cyclic low-dose estrogen/progestin/combined oral contraceptive (LEP/COC) in ameliorating dysmenorrhea pain and are recommended for dysmenorrhea treatment in Japan. However, their efficacy has not been directly compared with continuous LEP/COC regimens. Here, we evaluated the effectiveness of DNG0.5 compared to Yazflex<sup>®</sup> (YZF), a continuous LEP, in treating dysmenorrhea. Methods: The efficacy of DNG0.5 in treating dysmenorrhea was compared retrospectively with that of Yazflex, the longest continuously administered LEP/COC available in Japan. Results: The improvement rates of dysmenorrhea scores at 3 and 6 months post-treatment were 59.1% and 66.4% in the LEP group (<i>n</i> = 113) and 88.1% and 96.4% in the DNG0.5 group (<i>n</i> = 125), respectively. The complete resolution rate of dysmenorrhea at 6 months was 88.0% in the DNG0.5 group and 23.9% in the LEP group. These findings indicate that DNG0.5 was significantly more effective than LEP (<i>p</i> < 0.01). DNG0.5 exerted an early pain-suppressing effect, which continued to increase thereafter. Furthermore, the presence of endometrial polyps, uterine fibroids, or adenomyosis, which are risk factors for irregular genital bleeding, was examined. Among these, endometrial polyps were particularly more likely to cause bleeding and potentially reduce the effect of DNG0.5; however, even with these three risk factors, DNG0.5 was more effective than LEP in reducing pain. Conclusions: Dienogest was more effective than LEP in managing dysmenorrhea, even at a dosage of 0.5 mg twice daily. However, factors affecting irregular vaginal bleeding should be considered when prescribing DNG0.5.https://www.mdpi.com/2673-396X/6/1/12dysmenorrheadienogestdienogest 0.5 mg tabletsLEP/COCendometrial polypsuterine fibroids
spellingShingle Haruko Yokosuka
Comparative Study of 0.5 mg Dienogest Tablets (1 mg/Day) and Continuous Low-Dose Estrogen/Progestin for Dysmenorrhea: A Retrospective Analysis—Influence of Bleeding-Related Factors Such as Endometrial Polyps, Uterine Fibroids, and Adenomyosis
Endocrines
dysmenorrhea
dienogest
dienogest 0.5 mg tablets
LEP/COC
endometrial polyps
uterine fibroids
title Comparative Study of 0.5 mg Dienogest Tablets (1 mg/Day) and Continuous Low-Dose Estrogen/Progestin for Dysmenorrhea: A Retrospective Analysis—Influence of Bleeding-Related Factors Such as Endometrial Polyps, Uterine Fibroids, and Adenomyosis
title_full Comparative Study of 0.5 mg Dienogest Tablets (1 mg/Day) and Continuous Low-Dose Estrogen/Progestin for Dysmenorrhea: A Retrospective Analysis—Influence of Bleeding-Related Factors Such as Endometrial Polyps, Uterine Fibroids, and Adenomyosis
title_fullStr Comparative Study of 0.5 mg Dienogest Tablets (1 mg/Day) and Continuous Low-Dose Estrogen/Progestin for Dysmenorrhea: A Retrospective Analysis—Influence of Bleeding-Related Factors Such as Endometrial Polyps, Uterine Fibroids, and Adenomyosis
title_full_unstemmed Comparative Study of 0.5 mg Dienogest Tablets (1 mg/Day) and Continuous Low-Dose Estrogen/Progestin for Dysmenorrhea: A Retrospective Analysis—Influence of Bleeding-Related Factors Such as Endometrial Polyps, Uterine Fibroids, and Adenomyosis
title_short Comparative Study of 0.5 mg Dienogest Tablets (1 mg/Day) and Continuous Low-Dose Estrogen/Progestin for Dysmenorrhea: A Retrospective Analysis—Influence of Bleeding-Related Factors Such as Endometrial Polyps, Uterine Fibroids, and Adenomyosis
title_sort comparative study of 0 5 mg dienogest tablets 1 mg day and continuous low dose estrogen progestin for dysmenorrhea a retrospective analysis influence of bleeding related factors such as endometrial polyps uterine fibroids and adenomyosis
topic dysmenorrhea
dienogest
dienogest 0.5 mg tablets
LEP/COC
endometrial polyps
uterine fibroids
url https://www.mdpi.com/2673-396X/6/1/12
work_keys_str_mv AT harukoyokosuka comparativestudyof05mgdienogesttablets1mgdayandcontinuouslowdoseestrogenprogestinfordysmenorrheaaretrospectiveanalysisinfluenceofbleedingrelatedfactorssuchasendometrialpolypsuterinefibroidsandadenomyosis