This study aimed to assess whether dienogest (DNG) is also effective in patients with recurrent endometriosis based on multicenter data of 121 women who were clinically diagnosed as having recurrent endometriosis and treated for more than 24 weeks with DNG (2 mg daily). We evaluated the changes in endometriosis-associated pain scores (visual analog scale [VAS]), serum cancer antigen 125 (CA-125) levels, and endometrioma sizes following DNG medication in these women along with adverse events associated with DNG medication. The mean duration of DNG treatment was 57.80 (24.08) weeks, and during continuation of DNG, the mean VAS score was 5.03 (1.73) at baseline and significantly decreased to 2.46 (1.32) at 24 weeks after taking DNG. In subgroup analysis, the trend of pain-related symptoms was compared between the symptom-only recurrence group and the recurrent endometrioma group. In both groups, the pain scores decreased significantly during the first 24 weeks but remained relatively unchanged thereafter. Moreover, the size of recurrent endometriomas and CA-125 levels also decreased significantly compared to baseline. The mean size of recurrent endometriomas was 3.77 (1.59) cm in diameter and decreased to 2.74 (1.53) cm after 24 weeks of DNG treatment (P for trend < .001). The mean CA-125 level was 80.04 U/mL at baseline and significantly decreased to 33.11 U/mL after taking DNG for 24 weeks and lasted until 72 weeks (P for trend = .0288). Overall, 51 (42.15%) patients reported adverse events, and the most common one was irregular bleeding pattern (29.75%, 36/121). In conclusion, DNG was found to be effective in reducing the size of endometriomas and provided symptomatic relief in this cohort of women with recurrent endometriosis.
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