Lipid Metabolism During Treatment of Endometriosis with the Progestin Dienogest

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Abstract
The effects of a new progestational compound, dienogest (17 alpha-cyanomethyl-17 beta-hydroxy-estra-4,9-dien-3-one) on lipid metabolism have been studied in 84 otherwise healthy women with laparoscopically proven endometriosis. The women, aged 17 to 45, years were treated with 2 mg dienogest in tablet form daily for 24 weeks. The progestin was highly effective on endometriotic lesions and symptoms, showing an objective endoscopic and a subjective symptomatic improvement in 80% and 83% respectively. Triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol and the LDL-cholesterol/HDL-cholesterol ratio were determined before and after 1, 3 and 6 months use of the progestin. There was a maximum decrease of -5.8% in HDL-cholesterol and of -6.5% in triglycerides after 6 months of therapy vis-à-vis the pretreatment values. The maximum increase in LDL-cholesterol of +5.0% was recorded by the end of the first month of dienogest ingestion. The LDL-cholesterol/HDL-cholesterol ratio rose from 1.6 to 1.8 during the course of therapy. There were no significant changes. The data suggest that 2 mg dienogest has little influence on lipid metabolism and provides also in this respect a suitable approach to the hormonal therapy of endometriosis.