title: Dienogest in women with persistent endometriosis-related pelvic pain during norethisterone acetate treatment.
abstract: OBJECTIVE
  To evaluate patient satisfaction at 6-months dienogest (DNG) treatment in women with symptomatic rectovaginal endometriosis who had pain persistence and were unsatisfied after 6-months of norethisterone acetate (NETA) therapy.
  
  
  METHODS
  This 24-weeks pilot open-label prospective study enrolled 25 women. The main outcome was the degree of patient satisfaction measured by using a Likert scale. Secondary outcomes were to evaluate differences in endometriosis-related pain, quality of life, sexual function changes and volumetric nodules changes during DNG compared to NETA treatment.
  
  
  RESULTS
  Patient satisfaction improved at 3- and 6-months (p<0.001, respectively) treatment with DNG compared with baseline treatment with NETA. Six months DNG treatment decreased the intensity of all the endometriosis-associated pain (chronic pelvic pain, dyspareunia, dyschezia) compared to baseline (p<0.001 for all comparisons). Quality of life and quality of sexual life evaluated with the EHP-30 and FSFI, respectively, increased after 6 months treatment. The volume of the endometriotic nodules did not significantly change during treatment.
  
  
  CONCLUSIONS
  This study confirms the efficacy of DNG in treating symptomatic women with rectovaginal endometriosis even in a particular endometriotic subpopulation of NETA "resistant" patients. Further randomized clinical trials comparing these two progestins both in first than second line are warranted.
authors.affiliation: Department of Obstetrics and Gynaecology, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy. Electronic address: drmorottimatteo@gmail.com.
authors.forename: Matteo
authors.initials: M
authors.lastname: Morotti
authors.affiliation: Department of Obstetrics and Gynaecology, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
authors.forename: Fausta
authors.initials: F
authors.lastname: Sozzi
authors.affiliation: Department of Obstetrics and Gynaecology, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
authors.forename: Valentino
authors.initials: V
authors.lastname: Remorgida
authors.affiliation: Department of Obstetrics and Gynaecology, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Venturini
authors.affiliation: Department of Obstetrics and Gynaecology, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Ferrero
mesh_terms: D000328:Adult; D003276:Contraceptives, Oral / Q000627:therapeutic use*; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009277:Nandrolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009640:Norethindrone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077563:Norethindrone Acetate; D010147:Pain Measurement; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000209:etiology*; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D012002:Rectal Diseases / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D014623:Vaginal Diseases / Q000150:complications / Q000188:drug therapy*
chemical_list: D003276:Contraceptives, Oral; C023635:dienogest; D009277:Nandrolone; D000077563:Norethindrone Acetate; D009640:Norethindrone
keywords: Dienogest; Endometriosis; Norethisterone acetate; Pain; Progestins