Six-Month Dienogest Therapy Reduced the Endometrioma Size, Pelvic Pain, And CA-125 Levels

Background: Endometriosis affects approximately 10% of women of reproductive age and is associated with pelvic pain, infertility, and reduced quality of life. Dienogest is widely used for medical management. This study evaluated the effects of dienogest on endometrioma size, serum CA-125 levels, and pelvic pain. Methods: In this retrospective study, medical records of 45 women aged 18-49 years who received oral dienogest (2 mg/day) for at least six months were reviewed. Endometrioma size was assessed by ultrasound, pelvic pain using the Visual Analog Scale (VAS), and serum CA-125 levels from laboratory records. Baseline and six-month values were compared using the Wilcoxon test and correlations were analyzed using Spearman's test. Results: After six months of treatment, significant reductions were observed in endometrioma size and VAS scores (p<0.001) and CA-125 levels (p<0.001) compared with baseline. No significant correlation was found between endometrioma size and VAS scores or CA-125 levels either before or after treatment (p>0.05). A significant negative correlation was identified between patient age and post-treatment endometrioma size (r = -0.320, p<0.05). Conclusion: Six months of dienogest therapy was associated with significant improvements in lesion size, pain, and biochemical markers. Dienogest may represent an effective medical treatment option for symptomatic patients, particularly for those seeking to avoid surgery and preserve ovarian reserve.