Risk to bone health during treatment of endometriosis with dienogest

Access to the full content of this site is available only to registered healthcare professionals. Register to read more


  • Treatment for endometriosis with dienogest (DNG) associated with bone loss in 75%.
  • Clinical significance is unclear.

Why this matters

  • Endometriosis affects 10% of reproductive-aged women and is associated with pain and infertility.
  • DNG is a synthetic nortestosterone derivative that selectively binds to progesterone receptors and causes anovulation.

Key results

  • 75% of women experienced bone loss.
  • Bone mineral density (BMD) at the lumbar spine decreased after the first 6 mo (−2.2%±4.5%; P=.001) and at 1 y (−2.7%±5.4%; P=.001).
  • Differences in BMD were similar after 1 y and 2 y of treatment.
  • Pain and endometriosis recurrence was reduced in women using DNG.

Study design

  • Prospective cohort study.
  • Cohort taken from the Endometriosis Cohort a...