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The patients enrolled took Dienogest 2 mg as a single daily administration. Group B of long-term therapy patients (over 15 months) were compared with group A of short-term therapy patients (0\u201315 months). The effects of the drug on pain variation were assessed using the VAS scale and endometriomas dimensions through ultrasonographic evaluation. Furthermore, has been valuated the appearance of side effects and the effect of the drug on bone metabolism by performing MOC every 24 months in group B.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>157 patients were enrolled. The mean size of the major endometrioma progressively decreased from 33.2 mm (29.4\u201336.9) at T0 to 7 mm (0\u201315.8) after 108 months of treatment. We found a significant improvement in dysmenorrhea, dyspareunia, dyschezia and non-cyclic pelvic pain. As for the side effects, both groups complained menstrual alterations present in 22.9%. In 27.6% of group B, osteopenia was found. Group B had a higher percentage statistically significant of side effects such as headaches, weight gain and libido reduction compared to group A. 2<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Long-term therapy with Dienogest has proven effective in controlling the symptoms of the disease and reducing the size of endometriomas, with an increase in the positive effects related to the duration of the intake and in the absence of serious adverse events. Study approved by the \"Palermo 2\" Ethics Committee on July 2, 2012 No. 16.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00404-023-07271-7","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T10:02:28Z","timestamp":1701252148000},"page":"589-597","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Evaluation of long-term efficacy and safety of dienogest in patients with chronic cyclic pelvic pain associated with endometriosis"],"prefix":"10.1007","volume":"309","author":[{"given":"Antonio","family":"Maiorana","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9159-2691","authenticated-orcid":false,"given":"Marianna","family":"Maranto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5406-884X","authenticated-orcid":false,"given":"Vincenzo","family":"Restivo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2693-0263","authenticated-orcid":false,"given":"Daniele Lo","family":"Gerfo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Minneci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Mercurio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9372-5200","authenticated-orcid":false,"given":"Domenico","family":"Incandela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"issue":"3","key":"7271_CR1","first-page":"349","volume":"7","author":"C Mehedintu","year":"2014","unstructured":"Mehedintu C, Plotogea MN, Ionescu S, Antonovici M (2014) Endometriosis still a challenge. 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