- Observational Study for Adverse Effects and Discontinuation with Long-Term Post-Operative Hormonal Treatment for Endometriosis in Real-World Practice
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In Hye Kim, Hyungjoon Yoon, Hyun Joo Lee, Hye Kyung Noh, Jong Kil Joo, Ki Hyung Kim
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Kosin Med J. 2021;36(2):116-124. Published online December 31, 2021
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DOI: https://doi.org/10.7180/kmj.2021.36.2.116
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 Abstract
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Objectives
To evaluate the side effects and causes of discontinuation of either combined oral contraceptives or dienogest (DNG) used to prevent recurrence in patients with surgically confirmed endometriosis.
Methods
We retrospectively analyzed the medical records of 213 women with endometriosis who had been treated with combined oral contraceptives (ethinyl estradiol 0.02 mg/drospirenone 3 mg [EE/DRSP]) or DNG 2 mg for 12 months or more. The side effects reported by the patients, laboratory parameters, causes of discontinuation of medication, and recurrence rates were evaluated one, two, three, four, and five years after starting medication (Y1, Y2, Y3, Y4, and Y5).
Results
EE/DRSP were administered to 59 patients, while DNG was administered to 154 patients. The mean durations of postoperative use of EE/DRSP and DNG were 44.5 ± 22.6 months and 23.6 ± 13.5 months, respectively. The prevalence of side effects was 27.1%, 19.0%, 10.0%, 10.5%, and 7.4% in the EE/DRSP group and 29.2%, 15.7%, 14.0%, 23.1%, and 0.0% in the DNG group at Y1, Y2, Y3, Y4, and Y5, respectively. The discontinuation rates were 1.7%, 1.7%, 4.0%, 0.0%, and 7.4% at Y1, Y2, Y3, Y4, and Y5, respectively, in the EE/DRSP group and 10.4%, 3.3%, 4.0%, 3.8%, and 0.0% at the same times in the DNG group. The recurrence rates were less than 4% in both the groups.
Conclusions
The side effects of commonly prescribed postoperative hormone treatments were relatively mild, and the occurrence of side effects decreased with continuous administration. Further, the long-term use of postoperative hormone treatments is likely to prevent recurrence of endometriosis after surgery.
- The conservative management of ovarian endometrioma using cyst aspiration followed by dienogest medication: a pilot study
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Ha Eun Jung, Eun Hee Yu, Hyun Joo Lee, Jong Kil Joo, Yong Jin Na
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Received October 10, 2024 Accepted December 17, 2024 Published online February 24, 2025
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DOI: https://doi.org/10.7180/kmj.24.149
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Abstract
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- Background
The aim of this study was to evaluate the efficacy of ultrasonography-guided cyst aspiration followed by dienogest medication in the management of endometriomas in selected patients.
Methods
This study included 38 female patients diagnosed with endometrioma via transvaginal ultrasonography or pelvic magnetic resonance imaging. We performed needle aspiration of the contents of endometrioma followed by the administration of dienogest (2 mg) daily orally, and assessed changes in endometrioma size, cancer antigen-125, anti-Müllerian hormone, and a visual analog scale score for dysmenorrhea before and 3 months after the procedure.
Results
The diameter of the ovarian cysts decreased from a maximum of 4.35 cm before the procedure to 2.37 cm on follow-up ultrasonography, and seven of 56 endometriomas in 38 patients resolved completely as evaluated on transvaginal ultrasonography. Malignant cells were not found in any of the cases upon a cytologic examination of endometriotic cyst fluid. The mean cancer antigen-125 level decreased from 86.69 U/mL before the procedure to approximately 37.28 U/mL. There was no statistically significant difference in anti-Müllerian hormone before and after the procedure. The visual analog scale score decreased from 3.58 to 0.97 after aspiration.
Conclusions
Ultrasonography-guided cyst aspiration followed by dienogest administration allows cytological confirmation through relatively low-burden procedures and may increase patient compliance due to the reduction in ovarian cyst size.
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KOSIN UNIVERSITY COLLEGE OF MEDICINE
