Dienogest in Perimenopausal Women With Adenomyosis
Condition: Adenomyosis; Medication Adherence
MeSH terms: Adenomyosis
Study type: Observational

Summary: 
      Between September 2018 and December 2021, women who did not want further childbearing and
      received dienogest treatment for dysmenorrhea and/or hypermenorrhea were included in a
      retrospective chart review. Dienogest 2mg was prescribed once per day orally after completing
      the above-mentioned exam. The patient would return to our clinic on the 1st, 3rd, and 6th
      then every 3 months for a prescription. The primary outcome was successfully long-term (more
      than a year) dienogest use for pain and/or bleeding control. The secondary outcomes were the
      reasons for discontinuing dienogest treatment and the predictor of successful long-term
      treatment.
    

Detailed description: 
      Between September 2018 and December 2021, women who did not want further childbearing and
      received dienogest treatment for dysmenorrhea and/or hypermenorrhea were included in a
      retrospective chart review. The baseline demographic data included age, parity, delivery
      mode, and body mass index. Sonographic findings of adenomyosis, uterine size, and other
      gynecological lesions were recorded. Indications for dienogest treatment were analyzed, and
      women for pre-operative control or post-operative prevention of endometrioma were excluded.
      Women who were younger than 40 years old, with a post-treatment follow-up duration of fewer
      than 6 months, and medical conditions not suitable for dienogest treatment, such as known
      breast cancer, high thromboembolic effect, and smoking, were also excluded. The patients were
      further allocated into a younger group (more or equal to 40 years old and less than 45 years
      old) and an older group (more or equal to 45 years old to menopause).

      For women with symptomatic adenomyosis, the pain scales and pretreatment data, including
      hormonal status, complete blood cell counts, liver function tests, and cancer antigen 125
      (CA-125) as an indicator of endometriosis were recorded. Previous conservative treatment for
      adenomyosis was also reviewed. Dienogest 2mg was prescribed once per day orally after
      completing the above-mentioned exam. The patient would return to our clinic on the 1st, 3rd,
      and 6th then every 3 months for a prescription. During the treatment, blood tests and pelvic
      sonography would be performed every 6 months. Besides, a personal interview was also done for
      treatment effect evaluation and adverse effect management. Once the patient decided to
      discontinue the treatment, the follow-up started. The post-treatment follow-up interval was
      defined as the time frame between the day she stopped the dienogest treatment and her last
      visit on the medical record. The follow-up would include clinical symptoms of adenomyosis and
      laboratory or sonographic data if necessary. Menopause was defined when the FSH level was
      more than 30 mIU/mL with menopausal symptoms, such as hot flush, and no menstrual bleeding
      after stopping dienogest for a year.

      The primary outcome was successfully long-term (more than a year) dienogest use for pain
      and/or bleeding control. The secondary outcomes were the reasons for discontinuing dienogest
      treatment and the predictor of successful long-term treatment.
    

Intervention name(s): Dienogest
Intervention type(s): Drug
Intervention description(s): Dienogest 2mg was prescribed once per day orally
Other intervention name(s): Visanne, Bayer
Intervention MeSH terms: Dienogest
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Women with adenomyosis who did not want further childbearing and received dienogest
        treatment for dysmenorrhea and/or hypermenorrhea
      
Keywords: Adenomyosis; Perimenopause; Dienogest