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All Journal Jurnal Kebidanan Jurnal Kesehatan Reproduksi Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Medica Hospitalia Diponegoro International Medical Journal (DIMJ) Dinamika Kesehatan: Jurnal Kebidanan dan Keperawatan
Yuli Trisetiyono, Yuli
Unknown Affiliation
Dentistry Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Efficacy and Tolerability of Short-Term Hormonal Therapy Following Conservative Surgery for Endometriosis: Efficay and Clinical Tolerability of Short-Term Hormonal Treatment for Endometriosis Pain Trisetiyono, Yuli; Sarastry, Razmaeda; Dewantiningrum, Julian; Anityo Mochtar, Arufiadi; Kristanto, Herman; Thaufik Hidayat, Syarief
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 4 October2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i4.2588

Abstract

AbstractObjective: To compare the efficacy and tolerability of four short-term hormonal therapies; Dienogest (DNG), Depot Medroxyprogesterone Acetate (DMPA), continuous Combined Oral Contraceptive (COC), and Leuprolide Acetate (LA); administered for 12 weeks after conservative endometriosis surgery. Methods: This randomized, prospective, open-label study enrolled reproductive-aged women with surgically confirmed endometriosis. Participants were randomly assigned to receive DNG 2 mg daily, DMPA 150 mg intramuscularly every 12 weeks, continuous COC (ethinyl estradiol 0.03 mg and levonogestrel 0.15 mg) daily, or LA 3.75 mg intramuscularly every 4 weeks. Primary outcomes were changes in pain intensity (visual analog scale, VAS), hormonal markers (estradiol, E2), inflammatory markers (TNF-?), and the Menopause Rating Scale (MRS) as an indicator of tolerability. Data were analyzed using ANOVA with a significance level of p < 0.05. Results: All four regimens resulted in significant reductions in dysmenorrhea, dyspareunia, and chronic pelvic pain after 12 weeks (p < 0.001). E2 and TNF-? levels decreased significantly in all groups, with the greatest decline observed in the LA arm. No significant differences were found among regimens in pain reduction or biomarker changes (p > 0.05). MRS scores increased transiently at week 8, particularly in the LA group, reflecting hypoestrogenic effects, but decreased by week 12 in all groups. Conclusion: Short-term postoperative hormonal therapy with DNG, DMPA, COC, or LA effectively reduces pain and inflammatory markers following endometriosis surgery. Progestin-based therapies achieve comparable clinical efficacy to GnRH agonists with superior tolerability. Individualized selection based on symptom profile, side effects, and accessibility is recommended in accordance with ESHRE guidelines. Keywords: endometriosis-associated pain, Menopause Rating Scale, short-term hormonal therapy.
Co-Authors AA Sudharmawan, AA Anityo Mochtar, Arufiadi Artanto, Yosef Adi Besari Adi Pramono Ediwibowo Ambari Erwinanto, Erwinanto Hadijono, Raden Soerjo Hary Tjahjanto Herman Kristanto Irsan, Raissa Alifia Julian Dewantiningrum Kurube, Isabela Marsialina Mochtar, Arufiadi Anityo Mulyantoro, Inu Nur Farhanah, Nur Pramono, M Besari Adi Putri Sekar Wiyati Ratnasari Dwi Cahyanti, Ratnasari Dwi Riantyoko, Yoshi Sarastry, Razmaeda Setyasworo, Singgeh Teuku Mirza Iskandar, Teuku Mirza Thaufik Hidayat, Syarief Udjaja, Claudio Wardana, Setya Girindra Wibowo, Satrio Arief Zahwa, Kamila Zettira