Prolonged dydrogesterone exposure helps relieve chronic pelvic pain, dysmenorrhoea

Prolonged cyclical and continuous treatment regimens of dydrogesterone produce similar reduction in the severity of chronic pelvic pain and dysmenorrhoea, resulting in marked improvements in quality of life and sexual wellbeing, according to a study.

The 6-month study included 350 women aged 18–45 years who had endometriosis and chronic pelvic pain with or without dysmenorrhoea. The patients were treated with dydrogesterone 10 mg administered two or three times daily, either between the 5th and 25th days of the menstrual cycle (prolonged cyclical treatment regimen; n=273) or continuously (continuous treatment regimen; n=77).

The mean age at baseline of the cohort was 31.1 years. According to the revised American Fertility Society classification of endometriosis, 65 patients (18.6 percent) had disease stage I, 98 patients (28.0 percent) were stage II, 139 patients (39.7 percent) were stage III, and 48 patients (13.7 percent) were stage IV. The mean duration of the menstrual cycle was 28.3 days, and 297 women (84.9 percent) had dysmenorrhoea.

At 6 months, intensity of chronic pelvic pain on the 11-point numerical rating scale significantly decreased from baseline. This was true with both the prolonged cyclical and continuous treatment regimens (mean change from baseline, –3.3 vs –3.0, respectively), with no significant difference between the two groups.

Both regimens yielded marked improvements in the intensity of chronic pelvic pain, number of days in which analgesics were required, severity of dysmenorrhoea, sexual well-being, and health-related quality-of-life parameters.

Dydrogesterone had a favourable safety profile, and there were no serious adverse drug reactions reported during the study.