{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:01:53Z","timestamp":1784955713309,"version":"3.55.0"},"reference-count":93,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"crossref","award":["2023A1515010018"],"award-info":[{"award-number":["2023A1515010018"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"crossref","award":["2025A1515012542"],"award-info":[{"award-number":["2025A1515012542"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100021171","name":"Guangdong basic and applied basic research foundation","doi-asserted-by":"crossref","award":["2022A1515220143"],"award-info":[{"award-number":["2022A1515220143"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Youth Science Foundation Project of the Guangxi Hospital Division of The First Affiliated Hospital, Sun Yat-sen University","award":["YQ2025001"],"award-info":[{"award-number":["YQ2025001"]}]},{"name":"Youth Science Foundation Project of the Guangxi Hospital Division of The First Affiliated Hospital, Sun Yat-sen University","award":["YQ2024018"],"award-info":[{"award-number":["YQ2024018"]}]},{"name":"Colin Nova Project of the First Affiliated Hospital of Sun Yat-sen University","award":["R08013"],"award-info":[{"award-number":["R08013"]}]},{"name":"Jieyang Special Guidance Project for Science and Technology Innovation Development","award":["DZX083"],"award-info":[{"award-number":["DZX083"]}]},{"name":"Jieyang Healthcare and Medical Projects","award":["2022wsyl016"],"award-info":[{"award-number":["2022wsyl016"]}]},{"name":"Student Innovation Training Program of Sun Yat-Sen University","award":["20252700"],"award-info":[{"award-number":["20252700"]}]},{"name":"Student Innovation Training Program of Sun Yat-Sen University","award":["20252684"],"award-info":[{"award-number":["20252684"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>The most common symptom of endometriosis is pain. The pathogenesis of endometriosis-associated pain remains unclear. In this review, we illustrate the pathogenesis of endometriosis-associated pain and the mechanisms of dienogest acts on endometriosis-associated pain, as well as therapeutic applications targeting these processes, by searching the literature in PubMed and Web of Science until May 2026. Abnormal distribution of nerve fibers, central sensitization, imbalance of inflammatory and immune environment, and hypoxic stress contribute to the generation of endometriosis-associated pain. Dienogest, as a fourth-generation selective progesterone receptor agonist, plays a key role in the treatment of endometriosis-associated pain by reducing serum estrogen levels, alleviating inflammatory responses, regulating nerve growth factor, modulating control central nervous system allergies, and influencing the biological processes of endometriotic stromal cells. Moreover, its long-term safety and tolerability are relatively satisfactory according to clinical studies, making it an effective therapeutic agent for endometriosis.<\/jats:p>","DOI":"10.3390\/biom16081080","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:05:42Z","timestamp":1784819142000},"page":"1080","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Therapeutic Role of Dienogest in Endometriosis-Associated Pain: From Basics to Clinics"],"prefix":"10.3390","volume":"16","author":[{"given":"Ying","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning 530025, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning 530025, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaxi","family":"Mai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510050, China"},{"name":"Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, Guangzhou 510050, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4287-9469","authenticated-orcid":false,"given":"Hao","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510050, China"},{"name":"Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, Guangzhou 510050, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7141-8223","authenticated-orcid":false,"given":"Yanchun","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning 530025, China"},{"name":"Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510050, China"},{"name":"Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, Guangzhou 510050, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E363","DOI":"10.1503\/cmaj.220637","article-title":"Diagnosis and management of endometriosis","volume":"195","author":"Allaire","year":"2023","journal-title":"Can. 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