Treatment for Endometriosis with Dienogest

As a super specialized consultant for endometriosis across India, this is the most common question which is asked by the majority of the women who are suffering from endometriosis. 

The problem here is that the majority of the routine Gynaecologist do not have specialized training in endometriosis, and as a result of this in order to retain the patient, the commonest medication which is prescribed to the patient is DIENOGEST.

The verbal assurance and promises are that we can take this medication so that the size of the disease will go down and we can avoid surgery.

Unfortunately, since the majority of the women do not like to undergo a surgery, which is absolutely mandatory for them, and often fall prey to gimmicks of such non-specialised medical professionals. Diagnose is basically a progesterone and a sustained exposure or a daily exposure to diagnose only And Only benefits the patient in reduction of PAIN. 

Prior to starting dinogest, one has to remember that a detailed 3-D ultrasound has to be done for the patient in order to rule out DEEP and Nodular endometriosis. In the presence of DEEP endometriosis, Dinogest has no role in the reduction of the size of the nodules.

In fact, the size of the nodules would simply keep on increasing, even if the patient is taking Dinogest.

The patient should also note that this drug has NO role when the size of the endometriotic cyst is more than 5 cm. In the country of India, it is often seen that this drug is abused and girls and women, irrespective of the disease severity are prescribed. This drug is based on a false promise.

Another peculiar example where dinogest is often misused is in cases of extra pelvic endometriosis. Scar endometriosis, umbilical endometriosis, diaphragmatic, endometriosis, lung endometriosis, and inguinal endometriosis, in all these cases, the patient has absolutely no benefit from this drug. 

Patients often tend to forget the common side effects of Dinogest which include weight gain, water retention, and a generalized feeling of weakness.

Surprisingly patients who take this drug if they happen to read the package insert and the medical information which is provided with the drug, it is stated clearly that this drug is only for a temporary benefit and only for a temporary postponement of a planned surgery. 

Many times, this drug is also given to the patients following the surgery. However, we have covered the discussion on Post-surgical medications for endometriosis in a separate chapter, and I would request the viewers to go through that chapter as well.

The scenario in India continues to be unfortunate as a majority of the girls have prolonged exposure to this drug and ultimately end up losing their entire fertility. As a result of this endometriosis is to be treated best endometriosis doctor in India who is super specialized in the management of this disease and not by somebody who is a routine gynecologist.