The Effect of Dionegest Use on the Frequency of Fibromyalgia in Endometriosis
Condition: Fibromyalgia; Endometriosis Ovary; Dienogest
MeSH terms: Fibromyalgia; Myofascial Pain Syndromes; Endometriosis
Study type: Observational

Summary: 
      Endometriosis usually occurs during the reproductive period of women and poses a significant
      burden on quality of life and social costs. The estimated prevalence in premenopausal women
      is 10% in clinical studies and the frequency rises to 50% in symptomatic patients with pelvic
      pain and infertility. Observational studies in Europe estimated the prevalence to be 8-15 per
      1000 people.

      Fibromyalgia is a common musculoskeletal chronic painful condition that may be accompanied by
      cognitive impairment, somatic symptoms, fatigue, and psychiatric symptoms. The population
      frequency is given as 20-80 per 1000 people. Fibromyalgia is most often diagnosed in women
      aged 20-55 years; prevalence increases with age and is associated with a higher prevalence of
      comorbidities, including endocrine and genitourinary disorders. Co-existance of endometriosis
      and fibromyalgia is a special entity that has not been enlightened in detal yet.
    

Detailed description: 
      Although little is known about the causes of endometriosis, it is reported that women with
      endometriosis have a high rate of comorbidity with other chronic pain syndromes associated
      with peripheral and central changes in pain processing, including fibromyalgia, migraine
      headaches, inflammatory bowel disease, and painful bladder syndrome. Later, various studies
      conducted in different years showed that cross-organ sensitivity phenomenon, defined as the
      spread of harmful inputs (inflammation products, mediators, pathogens, etc.) from a diseased
      visceral organ to a normal organ, comorbidities including IBS, IBD, interstitial cystitis and
      chronic pelvic pain disorders are common. Therefore, it has been suggested that patients with
      endometriosis may have a higher risk of developing these chronic diseases. The results of
      another study are inconsistent with the studies that supports the coexistence of
      endometriosis and fibromyalgia.

      These literature data indicate the need for more data on the frequency of fibromyalgia in
      women with endometriosis. On the other hand, it has been reported that pain scores are
      correlated with daily fluctuations of progesterone and testosterone in women with
      fibromyalgia, and progesterone and testosterone play a protective role for fibromyalgia pain.
      Dienogest is a fourth-generation selective progestin that has a significant local effect on
      endometriotic lesions, has little androgenic, less estrogenic, low glucocorticoid or
      mineralocorticoid activity and minimal effect on metabolic parameters, and is used in the
      medical treatment of endometriosis. However, there is no data on the effects of hormonal
      therapy used in the treatment of endometriosis on the frequency and severity of symptoms of
      fibromyalgia associated with endometriosis. Therefore, in this study, it was aimed to
      evaluate the effects of progesterone therapy used in endometriosis patients on fibromyalgia
      frequency, fibromyalgia severity and quality of life.
    

Intervention name(s): Dienogest
Intervention type(s): Drug
Intervention description(s): Assessment of fibromyalgia effects after the use of dienogest
Intervention MeSH terms: Dienogest
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Women who applied to Gaziosmanpasa Training and Research Hospital Gynecology and Obstetrics
        Polyclinic, previously diagnosed with fibromyalgia and diagnosed with unilateral
        endometrioma.