Dienogest on the PBS

Dienogest is now available on the Pharmaceutical Benefits Scheme (PBS) for the treatment of endometriosis. It is estimated that one in seven Australian women have this condition, which can cause pain, impair fertility, and affect overall quality of life.

Dienogest is a progestogen and has an inhibitory effect on endometrial cell proliferation. When taken continuously, dienogest produces atrophy of endometriotic lesions. A meta-analysis evaluating the efficacy of dienogest following surgery suggests that dienogest is more effective than placebo in reducing disease and pain recurrence. Dienogest was also found to be as effective and better tolerated than gonadotrophin-releasing hormone (GnRH) agonists.

Dienogest is usually prescribed at a dose of 2mg each day. Most women taking dienogest will experience changes in their menstrual bleeding pattern. Other common adverse effects include headache, breast discomfort, depressed mood, and acne. As dienogest suppresses estradiol production, concerns about its effects on bone health exist. Studies demonstrate a reduction in bone mineral density over the first 12 months of dienogest therapy, although the clinical significance of this is not clear. Risk factors for osteoporosis should be taken into account when considering the risks and benefits of dienogest therapy.