Dienogest as an alternative to progesterone component in endometriosis

Dienogest: Facts to be kept in mind are: - 1) the side effects of Visanne ( brand name of dienogest of -Bayer) are Chloasma, depression, irregular bleeding, ovarian cyst formation. wt gain, & nausea.  The side effects , however may be less if 1 mg dose (anovulatory dose) is used .This mini dose will help some of the women specially those who are sufferer of endometriosis but have much side effects with standard 2 mg dose . the other options for BTB is to prescribe  combination of Dienogest with natural   Oestrogen. Hopefully such product  will  have less side effects than Dienogest 2 mg alone .So it may be relevant to remember if a woman who has been prescribed Dienogest 2 mg and complains of BTB then one can switch over to newly marketed COC ( containg Dienogest 1 mg with natural oestrogen i,.e estradiol valerate) .

. The idea of prescribing Dienogest containing natural oestrogens stems from the fact such drugs will ensure monthly bleeds & possibly assure the woman concerned,  that all is well. Many gynecologists will purposefully intend to avoid EE (synthetic agent) which is a very potent oestrogen which theoretically may exert more harmful effect on the existing pathology as endometriosis is often oesrogens driven disease.

Such combinations of natural oestrogens with Dienogest are QLARIA –polyphasic preparations (marketed by Bayer) and the Oestrogen  component used is E2V (valerate). The other trade names are Klaira, Natazia. –all  are quadriphasic.