{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T22:43:29Z","timestamp":1782168209494,"version":"3.54.5"},"reference-count":40,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Almost 10% of women in reproductive age are diagnosed with ovarian endometriomas and can experience symptoms and infertility disorders. Ovarian endometriomas can be treated with medical or surgical therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess whether long-term therapy with dienogest or oral cyclic estrogen-progestogens is effective in reducing the size of ovarian endometriomas, alleviating associated symptoms, and reducing the requirement for surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Prospective non-interventional cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We enrolled childbearing women diagnosed with ovarian endometriomas. We collected demographic, clinical, and surgical data, including the evaluation of ovarian endometrioma-associated symptoms and pain using the visual analog scale. We grouped the women according to treatment regimen into dienogest, estrogen-progestogens, and no-treatment. Patient\u2019s assessment was performed at baseline and after 12 months evaluating the largest ovarian endometrioma diameter (in millimeters) and the associated symptoms. Furthermore, we analyzed the impact of hormonal treatment in a sub-group of women fulfilling at baseline the criteria for a first-line surgical approach (ovarian endometrioma\u2009&gt;\u200930 mm with visual analog scale\u2009&gt;\u20098 or ovarian endometrioma\u2009&gt;\u200940 mm before assisted reproductive treatments or any ovarian endometrioma(s)\u2009&gt;\u200960 mm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We enrolled 142 patients: 62, 38, and 42 in dienogest, estrogen-progestogens, and no-treatment groups, respectively. No significant differences were found regarding baseline characteristics. After 12 months, the mean largest ovarian endometrioma diameter increased in the no-treatment group (31.1 versus 33.8; p\u2009&lt;\u20090.01), while a significant reduction was registered in the dienogest (35.1 versus 25.8; p\u2009&lt;\u20090.01) and estrogen-progestogens (28.4 versus 16.7; p\u2009&lt;\u20090.01) groups; no significant difference in ovarian endometrioma diameter reduction between these two latter groups was noted (p\u2009=\u20090.18). Ovarian endometrioma-associated symptoms and pain improved in dienogest and estrogen-progestogens groups, with a significantly greater effect for dienogest than for estrogen-progestogens for dysmenorrhea (74% versus 59%; p\u2009&lt;\u20090.01). In the sub-group of women eligible for first-line surgery at baseline, long-term treatment with dienogest and estrogen-progestogens reduced surgical eligibility by 30%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Decreased mean largest ovarian endometriomas\u2019diameter after 12 months and reduction of the need for surgical treatment by 30% were observed in dienogest and estrogen-progestogens groups. Long-term treatment with dienogest had a greater effect in alleviating dysmenorrhea and pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057241252573","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:49:32Z","timestamp":1715582972000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Long-term therapy with dienogest or other oral cyclic estrogen-progestogen can reduce the need for ovarian endometrioma surgery"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7065-2432","authenticated-orcid":false,"given":"Federico","family":"Ferrari","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy"},{"name":"S.C. Ginecologia e Ostetricia, ASST Spedali Civili di Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8841-6961","authenticated-orcid":false,"given":"Matteo","family":"Epis","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jvan","family":"Casarin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cFilippo Del Ponte\u201d Hospital, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Bordi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cFilippo Del Ponte\u201d Hospital, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele Baldo","family":"Gisone","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cFilippo Del Ponte\u201d Hospital, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Cattelan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cFilippo Del Ponte\u201d Hospital, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego Oreste","family":"Rossetti","sequence":"additional","affiliation":[{"name":"S.C. Ginecologia e Ostetricia, ASST Spedali Civili di Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Ciravolo","sequence":"additional","affiliation":[{"name":"S.C. Ginecologia e Ostetricia, ASST Spedali Civili di Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Gozzini","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy"},{"name":"S.C. Ginecologia e Ostetricia, ASST Spedali Civili di Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Conforti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy"},{"name":"S.C. Ginecologia e Ostetricia, ASST Spedali Civili di Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Cromi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cFilippo Del Ponte\u201d Hospital, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1543-2802","authenticated-orcid":false,"given":"Antonio Simone","family":"Lagan\u00e0","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy"},{"name":"Unit of Obstetrics and Gynecology, \u201cPaolo Giaccone\u201d Hospital, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Ghezzi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cFilippo Del Ponte\u201d Hospital, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Odicino","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy"},{"name":"S.C. 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,13]]},"reference":[{"key":"bibr1-17455057241252573","doi-asserted-by":"publisher","DOI":"10.3390\/ijms241612663"},{"key":"bibr2-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoac009"},{"key":"bibr3-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.04.041"},{"key":"bibr4-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14337"},{"key":"bibr5-17455057241252573","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11133914"},{"key":"bibr6-17455057241252573","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1387036"},{"key":"bibr7-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24936"},{"key":"bibr8-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2022.04.016"},{"key":"bibr9-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70247-4"},{"key":"bibr10-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2016.02.035"},{"key":"bibr11-17455057241252573","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.1203816"},{"key":"bibr12-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1177\/2284026518808159"},{"key":"bibr13-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2014.12.101"},{"key":"bibr14-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0245-z"},{"key":"bibr15-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2018.01.015"},{"key":"bibr16-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2009.01076.x"},{"key":"bibr17-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12811"},{"key":"bibr18-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2019.1640199"},{"key":"bibr19-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2019.04.010"},{"key":"bibr20-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2019.1640674"},{"key":"bibr21-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2020.1725965"},{"key":"bibr22-17455057241252573","doi-asserted-by":"publisher","DOI":"10.11152\/mu-2331"},{"key":"bibr23-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002469"},{"key":"bibr24-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2010.01.055"},{"key":"bibr25-17455057241252573","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"bibr26-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2019.1703942"},{"key":"bibr27-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2020.1867962"},{"key":"bibr28-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2010.04.002"},{"key":"bibr29-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.02.045"},{"key":"bibr30-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.07.1165"},{"key":"bibr31-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.10.022"},{"key":"bibr32-17455057241252573","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.14817.1"},{"key":"bibr33-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.08.009"},{"key":"bibr34-17455057241252573","doi-asserted-by":"publisher","DOI":"10.3109\/09513590.2016.1142523"},{"key":"bibr35-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12338"},{"key":"bibr36-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-021-06129-0"},{"key":"bibr37-17455057241252573","doi-asserted-by":"publisher","DOI":"10.23736\/S2724-606X.21.04784-5"},{"key":"bibr38-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01846-3"},{"key":"bibr39-17455057241252573","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmt053"},{"key":"bibr40-17455057241252573","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12051858"}],"container-title":["Women's 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