Objective: To compare the short-term effects of dienogest and oral contraceptives (OCPs) on pain and quality of life in women with endometriosis.
Method: The databases including PubMed, Cochrane Library, Embase, Web of Science, CNKI, and Wanfang Database were searched, and the date ranged from the establishment of the database to November 2024. The randomized controlled trials (RCTs) compared the efficacy of dienogest and oral contraceptives in the treatment of endometriosis were included. The indicators for evaluation mainly included pain score and quality of life. The secondary indicator was safety.
Results: Eight studies were included in this meta-analysis. Subgroup analysis was used to assess the endometriosis-related pain because patients received different types of OCPs. Dienogest was superior to mifepristone and Yasmin in improving VAS scores (P = 0.04, SMD=-1.19, 95%CI=-2.32 to -0.06; P = 0.03, SMD=-1.66, 95%CI=-3.16 to -0.15). However, Dienogest was not as effective as OCPs in improving pelvic pain and dyspareunia associated with endometriosis (P = 0.009, SMD = 0.42, 95%CI = 0.11 to 0.73; P = 0.006, SMD = 0.70, 95%CI = 0.20 to 1.19). For QoL score, compared to OCPs, dienogest significantly improved EHP-5, EHP-30, and SF-12 average PCS scores (P < 0.05), but there was no significant difference in SF-12 average MCS and WHO-QoL scores (P > 0.05). For side effects after treatment, there is no significant difference in the risk of vaginal bleeding, headache, hot flashes, back pain, skin dryness, and nausea between dienogest and OCPs. But, OCPs increase the risk of hand numbness and weight gain.
Conclusion: Dienogest is superior to OCPs in improving pain and QoL in patients with endometriosis, but not as effective as OCPs in pelvic pain and dyspareunia, and the safety was similar between the two types of drugs.
Keywords: Dienogest; Endometriosis; Oral contraceptives; Pain; Quality of life.
© 2025. The Author(s).