The effect of dienogest and gonadotropin-releasing hormone agonist on pelvic pain after laparoscopic surgery for endometriosis: An RCT

Fatemeh Davari Tanha, Azam Rasti, Hamideh Pakniat, Shohreh Salimi Setudeh
International journal of reproductive biomedicine · 2025 · vol. 22(12) , pp. 995–1002 · doi:10.18502/ijrm.v22i12.18065 · PMID:39968367 · W4407265062
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This RCT found that dienogest and GnRH agonists equally reduced pelvic pain in endometriosis patients post-surgery, but caused different adverse effects, notably more vaginal dryness and decreased libido with GnRH agonists.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This randomized controlled trial compared postoperative pelvic pain outcomes after laparoscopic surgery for endometriosis using dienogest versus a gonadotropin-releasing hormone agonist. Participants were followed after surgery to assess pelvic pain as the primary outcome, with the study designed to directly contrast the two hormonal regimens. The main reported result was the relative effect of dienogest and the gonadotropin-releasing hormone agonist on pelvic pain following laparoscopy, with a caveat that the brief provided record does not include effect sizes, follow-up duration, or explicit limitations stated by the authors. This paper is centrally about endometriosis — it evaluates dienogest versus GnRH agonist for pelvic pain after laparoscopic endometriosis surgery.

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Abstract

Background: 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. Objective: This study aimed to investigate the efficacy of dienogest and GnRH agonists in improving pelvic pain after laparoscopic surgery for endometriosis. Materials and Methods: 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. Results: 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. Conclusion: 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.
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Publication International Journal of Reproductive BioMedicine (IJRM) Record type Journal article Published 3 February 2025 Authors Fatemeh Davari Tanha | Azam Rasti | Hamideh Pakniat | Shohreh Salimi Setudeh The publisher of this work supports multiple resolution. The work is available from the following locations: {'doi': '10.18502/ijrm.v22i12.18065', 'member_id': '7770', 'member': 'Knowledge E DMCC', 'container-title': 'International Journal of Reproductive BioMedicine (IJRM)', 'primary-resource': 'https://knepublishing.com/index.php/ijrm/article/view/18065', 'tld': 'knepublishing.com', 'clearbit-logo': '/static/no_logo.svg', 'coaccess': [], 'multiple-resolution': [{'url': 'https://ijrm.ir/article-1-3280-en.html', 'tld': 'ijrm.ir', 'clearbit-logo': '/static/no_logo.svg'}], 'type': 'JOURNAL ARTICLE', 'published_date': '3 February 2025', 'publication': 'International Journal of Reproductive BioMedicine (IJRM)', 'title': 'The effect of dienogest and gonadotropin-releasing hormone agonist on pelvic pain after laparoscopic surgery for endometriosis: An RCT', 'name': None, 'id': None, 'location': None, 'display_doi': 'https://doi.org/10.18502/ijrm.v22i12.18065', 'grant_info': None, 'grant_info_funders': None, 'grant_info_funder_ids': '', 'grant_info_type': None, 'multiple_lead_investigators': [], 'multiple_co_lead_investigators': [], 'multiple_investigators': [], 'finances': [], 'project_description': None, 'award_amount': None, 'award_start': None, 'funding_scheme': None, 'internal_award_number': None, 'editors': None, 'authors': 'Fatemeh Davari Tanha | Azam Rasti | Hamideh Pakniat | Shohreh Salimi Setudeh', 'chairs': None, 'supplementary_ids': None} https://doi.org/10.18502/ijrm.v22i12.18065 JSON XML

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Outcome instruments

VAS-pain

Condition tags

endometriosischronic_pelvic_pain

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