{
    "abstract": "To determine which progestin, norethindrone acetate (NETA) or dienogest, is more effective in alleviating pain associated with endometriosis?\nThis single-center, prospective, randomized trial included 70 patients aged 18-40\u00a0years attending the Endometriosis Clinic (April 2022-April 2023). Participants were randomly assigned to receive either NETA (5\u00a0mg daily) or dienogest (2\u00a0mg daily). Pain levels were assessed using a visual analog scale (VAS) at baseline and at 6- and 12-month follow-ups. Discontinuation rates, dropout reasons, and side effects were also recorded.\nThe study included 70 patients, with 40 randomized to the dienogest group and 30 to the NETA group. Both groups showed significant reductions in pain scores at all follow-ups, with no significant differences between them. At baseline, dysmenorrhea scores were 7.43\u00a0\u00b1\u00a02.9 (NETA) and 7.23\u00a0\u00b1\u00a02.87 (dienogest). By 12\u00a0months, both groups had a dysmenorrhea score of 0.00\u00a0\u00b1\u00a00.00. Chronic pelvic pain scores improved to 1.06\u00a0\u00b1\u00a02.43 (NETA) and 0.00\u00a0\u00b1\u00a00.00 (dienogest) (p\u00a0=\u00a00.058). NETA demonstrated a significantly greater reduction in endometrioma size (p\u00a0=\u00a00.037). At the sixth month, there were 23 patients in the NETA group and 21 patients in the dienogest group, while 16 patients in the NETA group and 18 patients in the dienogest group completed the treatment. Side effect profiles were comparable; however, the dropout rate at six months was higher in the dienogest group (47.5\u00a0% vs. 23.3\u00a0%; p\u00a0=\u00a00.026).\nBoth progestins effectively reduced pain scores, but NETA achieved a greater reduction in endometrioma size and had a lower dropout rate, potentially due to its higher dose. These findings suggest NETA 5\u00a0mg/day may be a better approach instead of dienogest for the endometriosis treatment.\nInternational Clinical Trials Registry Platform No. NCT05476172.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics and Gynecology, Uludag University, Bursa, T\u00fcrkiye; Department of Obstetrics and Gynecology, Duzce Ataturk State Hospital, Duzce, T\u00fcrkiye.",
            "firstname": "Tansu Bahar",
            "initials": "TB",
            "lastname": "Gurbuz"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Uludag University, Bursa, T\u00fcrkiye.",
            "firstname": "Kiper",
            "initials": "K",
            "lastname": "Aslan"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Uludag University, Bursa, T\u00fcrkiye.",
            "firstname": "Isil",
            "initials": "I",
            "lastname": "Kasapoglu"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Sapienza University, Rome, Italy.",
            "firstname": "Ludovico",
            "initials": "L",
            "lastname": "Muzii"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Uludag University, Bursa, T\u00fcrkiye. Electronic address: guncu@uludag.edu.tr.",
            "firstname": "Gurkan",
            "initials": "G",
            "lastname": "Uncu"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025 Elsevier B.V. All rights reserved.",
    "doi": "10.1016/j.ejogrb.2025.113940",
    "journal": "European journal of obstetrics, gynecology, and reproductive biology",
    "keywords": [
        "Chronic pelvic pain",
        "Dienogest",
        "Endometriosis",
        "Norethindrone acetate",
        "Progestin"
    ],
    "methods": null,
    "publication_date": "2025-04-16",
    "pubmed_id": "40233572",
    "results": "The study included 70 patients, with 40 randomized to the dienogest group and 30 to the NETA group. Both groups showed significant reductions in pain scores at all follow-ups, with no significant differences between them. At baseline, dysmenorrhea scores were 7.43\u00a0\u00b1\u00a02.9 (NETA) and 7.23\u00a0\u00b1\u00a02.87 (dienogest). By 12\u00a0months, both groups had a dysmenorrhea score of 0.00\u00a0\u00b1\u00a00.00. Chronic pelvic pain scores improved to 1.06\u00a0\u00b1\u00a02.43 (NETA) and 0.00\u00a0\u00b1\u00a00.00 (dienogest) (p\u00a0=\u00a00.058). NETA demonstrated a significantly greater reduction in endometrioma size (p\u00a0=\u00a00.037). At the sixth month, there were 23 patients in the NETA group and 21 patients in the dienogest group, while 16 patients in the NETA group and 18 patients in the dienogest group completed the treatment. Side effect profiles were comparable; however, the dropout rate at six months was higher in the dienogest group (47.5\u00a0% vs. 23.3\u00a0%; p\u00a0=\u00a00.026).",
    "title": "Norethindrone acetate versus dienogest for pain relief in endometriosis related pain: A randomized controlled trial.",
    "xml": "<Element 'PubmedArticle' at 0x788504d2cc20>"
}