Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.63231/2595-0118.20250042-en
Brazilian Journal of Pain
Original Article

Evaluation of endometrial thickness and pain symptoms in women with deep endometriosis using dienogest: retrospective cohort

Avaliação da espessura endometrial e sintomas de dor em mulheres com endometriose profunda usando dienogeste: coorte retrospectiva

Danielle Mutta; João Paulo Leonardo Pinto; Cristina Laguna Benetti-Pinto; Daniela Angerame Yela

http://dx.doi.org/10.63231/2595-0118.20250042-en BrJP, vol.8, e20250042, 2025
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Abstract

BACKGROUND AND OBJECTIVES: Endometriosis is a chronic, inflammatory and estrogen-dependent disease. The most common symptoms include dysmenorrhea, dyspareunia, chronic pelvic pain and infertility. The study’s objective is to evaluate the effect of dienogest on endometrial thickness and correlate it with pain symptoms in women with deep endometriosis.

METHODS: Retrospective cohort study with 104 women diagnosed with deep endometriosis from a tertiary hospital from 2018 to 2022. The variables of sociodemographic characteristics of women, pain symptoms at the beginning of treatment with dienogest and after one year, in addition to the endometrial thickness measured by ultrasound were evaluated at the beginning of treatment and after one year of using dienogest.

RESULTS: The average age of the women was 36.0±6.3 years, the majority were white (81.7%), nulliparous (44.2%), with a partner (68.2%) and with a body mass index of 27.6± 5.4 kg/m2. Among the study participants, 41.3% had undergone previous surgeries and only 15.3% had another comorbidity. There was better control of dysmenorrhea (p<0.001) and dysuria (p=0.031) with the use of dienogest. The greater the endometrial thickness, the greater the dysmenorrhea (p=0.04). There was no correlation between endometrial thickness and other pain symptoms.

CONCLUSION: The use of dienogest for 12 months reduced dysmenorrhea and dysuria but did not reduce other pain complaints. Endometrial thickness is directly related to dysmenorrhea.

Keywords

 Dysmenorrhea; Pelvic pain; Endometriosis

Resumo

JUSTIFICATIVA E OBJETIVOS: A endometriose é uma doença crônica, inflamatória e dependente de estrogênio. Os sintomas mais comuns incluem dismenorreia, dispareunia, dor pélvica crônica e infertilidade. O objetivo do estudo foi avaliar o efeito do dienogeste na espessura endometrial e correlacioná-lo com os sintomas de dor em mulheres com endometriose profunda.

MÉTODOS: Estudo de coorte retrospectivo com 104 mulheres diagnosticadas com endometriose profunda de um hospital terciário de 2018 a 2022. Foram avaliadas as variáveis ​​características sociodemográficas das mulheres, sintomas de dor no início do tratamento com dienogeste e após um ano, além da avaliação da espessura endometrial medida por ultrassonografia no início do tratamento e após um ano de uso do dienogeste.

RESULTADOS: A média de idade das mulheres foi de 36,0±6,3 anos, a maioria era branca (81,7%), nulípara (44,2%), com companheiro (68,2%) e apresentava índice de massa corporal de 27,6±5,4 kg/m2. Entre as participantes, 41,3% haviam passado por cirurgias prévias e apenas 15,3% apresentavam outra comorbidade. Houve melhor controle da dismenorreia (p<0,001) e da disúria (p=0,031) com o uso do dienogeste. Quanto maior a espessura endometrial, maior a dismenorreia (p=0,04). Não houve correlação entre a espessura endometrial e outros sintomas de dor.

CONCLUSÃO: O uso do dienogeste por 12 meses reduziu a dismenorreia e a disúria, mas não reduziu outras queixas de dor. A espessura endometrial está diretamente relacionada à dismenorreia.

Palavras-chave

Dismenorreia; Dor pélvica; Endometriose

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Submitted date:
10/09/2024

Accepted date:
07/23/2025

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