Beatriz Porto

Santa Casa de Misericordia de Sao Paulo, Brazil

Title: Effects of Levonorgestrel IUS and Dienogest on Quality of Life in Deep Endometriosis: Results from a Randomized Clinical Trial

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Biography

Beatriz da Costa Porto is a gynecologist and obstetrician with expertise in laparoscopy and hysteroscopy. She graduated from the University of Marilia , with a master's and doctorate from the Faculty of Medical Sciences of Santa Casa de Sao Paulo. She is currently a partner at the "Misclinica" clinic, a volunteer doctor and assistant at Santa Casa de Sao Paulo, and a doctor on the clinical staff at Albert Einstein Hospital.

Abstract

Objectives: To evaluate whether the levonorgestrel-releasing intrauterine system (LNG-IUS) is non-inferior to oral dienogest (DNG) in improving the quality of life (QoL) of women with deep infiltrating endometriosis (DIE). 

Scope: This study focuses on women with DIE who have not undergone prior surgical treatment and who do not have an indication or wish to undergo surgery immediately. The study investigates the therapeutic impact of two progestin-based interventions (LNG-IUS and DNG) on quality of life (QoL) outcomes over a six-month period. 

Methods: A randomized, open-label clinical trial was conducted with forty women with DIE, as confirmed by clinical history, physical examination, transvaginal ultrasonography and pelvic magnetic resonance imaging. Participants underwent a three-month washout period from hormonal treatments before being assigned to receive either LNG-IUS or DNG for six months. Quality of life was assessed at baseline and after treatment using the SF-36 and EHP-30 questionnaires. 

Results: Significant improvement was observed in all SF-36 domains in both treatment groups (p < .001), with no statistically significant difference between LNG-IUS and DNG (p > .05 for all domains). Similarly, both interventions improved all EHP-30 domains (p < .001), except for 'relationship with children' and 'feelings about pregnancy'. Again, no significant differences were found between the two groups in any section scores (p > .05). 

Conclusions: Treatment with either LNG-IUS or dienogest is associated with a significant improvement in quality of life (QoL) among women with deep infiltrating endometriosis who have not undergone surgical intervention. Both therapies appear to be equally effective, which supports the use of LNG-IUS as an alternative to oral dienogest.