Resolution of the First Ukrainian endometriosis forum “Drug treatment for endometriosis-associated pelvic pain. The quality of a woman’s life”




resolution, Endometriosis Forum, progestogens, dydrogesterone, algorithms


Endometriosis affects 10% of all women of reproductive age, i.e. 190 million patients. Ukraine currently does not gather statistics on the incidence of endometriosis, but, at a rough estimate, this number is approximately 280 thousand women and the real number may be higher. Endometriosis has known significant social, medical and economic impact. Therefore, Ukrainian leading specialists in obstetrics and gynecology focus on new treatments for endometriosis, given current scientific data and the needs of patients.
The given resolution and algorithms for treatment for endometriosis are the common stand of leading specialists in gynecology in our country and were developed on the basis of modern domestic and foreign data and current clinical guidelines. This resolution aims to improve clinical approaches to the routine practice of treatment for endometriosis.
The constant increase in the incidence of endometriosis and its management characteristics allows to conduct an extensive study of the effectiveness and safety profile of various progestogens. In recent years, a number of further evidence have appeared regarding dydrogesterone treatment for endometriosis. New data on the effectiveness of dydrogesterone offer another hormone-based treatment for endometriosis, which is extremely important given the need for long-term and individualized treatment for endometriosis.
The Europ ean Society of Human Reproduction and Embryology (ESHRE) states that the degree of pain relief in endometriosis is the same for all hormone-based treatments, but the safety and tolerability profiles of different medicinal products differ, which must be considered.
According to the obtained data on the effectiveness and metabolic safety profile of various progestogens and during the discussion, algorithms for dydrogesterone-based treatment for endometriosis were proposed.

Author Biographies

A.V. Boichuk, Еducational and Scientific Institute of Postgraduate Education of I.Y. Horbachevskyi Ternopil State Medical University of the MOH of Ukraine, Ternopil

MD, professor, head of the Obstetrics and Gynaecology Department

D.G. Herman, City Hospital No. 1, Mykolaiv

PhD, medical director of the obstetrics and gynecology

Y.O. Dubossarska, Dnipro State Medical University, Dnipro

MD, professor, head of the Obstetrics, Gynecology and Perinatology Department, Faculty of Postgraduate Education

N.F. Zakharenko, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”; Institute for Planning Family Clinic, Kyiv

MD, professor, leading research fellow, Endocrine Gynecology Department;
Chairman of the Academic Council

L.V. Kalugina, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”, Kyiv

MD, leading researcher, Endocrine Gynecology Department

N.V. Kosei, SSI “Center for Innovative Medical Technologies of the NAS of Ukraine», Kyiv

MD, professor, head of Department of Reproductive Health

S.I. Reheda, SSI “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv

PhD, head of the Gynecology Department

N.M. Rozhkovska, Odesa National Medical University, Odesa

MD, professor, Obstetrics and Gynecology Department

T.F. Tatarchuk, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”, Kyiv

MD, professor, corresponding member of the NAMS of Ukraine, deputy director for research work, head of the Endocrine Gynecology Department

O.V. Trokhymovich, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”, Kyiv

MD, head of the Department of Medical Problems of Family Planning

O.G. Yashina, Medicom Clinic, Kyiv

PhD, leading specialist

N.V. Yarotska, SSI “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv

Psychologist, researcher, Department of Reproductive Health


  1. World Health Organization. Fact Sheet: Endometriosis [Internet]. 2021. Mar 24. Available from:
  2. Nnoaham KE, Hummelshoj L, Webster P, et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril 2011;96(2):366–73. DOI: 10.1016/j.fertnstert.2011.05.090
  3. Eisenberg VH, Weil C, Chodick G, Shalev V. Epidemiology of endometriosis: a large population-based database study from a healthcare provider with 2 million members. BJOG 2018 Jan;125(1):55–62. DOI: 10.1111/1471-0528.14711
  4. Hudelist G, Fritzer N, Thomas A, et al. Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod 2012 Dec;27(12):3412–6. DOI: 10.1093/humrep/des316
  5. Press Release: Endometriosis Action Month 2023 [Internet]. 2023. Available from:
  6. Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Open. 2022 Feb 26;2022(2):hoac009. DOI:10.1093/hropen/hoac009
  7. Dunselman G A J, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014 Mar;29(3):400–12. DOI: 10.1093/humrep/det457
  8. Chen-Dixon K, Uzuner C, Mak J, Condous G. Effectiveness of ultrasound for endometriosis diagnosis. Curr Opin Obstet Gynecol. 2022 Oct;34(5):324–31. DOI:10.1097/GCO.0000000000000812
  9. Bourdel N, Alves J, Pickering G, et al. Systematic review of endometriosis pain assessment: how to choose a scale? Hum Reprod Update. 2015 Jan-Feb;21(1):136–52. DOI: 10.1093/humupd/dmu046
  10. Gerlinger C, Schumacher U, Wentzeck R, et al. How can we measure endometriosis-associated pelvic pain? Journal of Endometriosis. 2012 Oct;4(3):109–16. DOI: 10.5301/JE.2012.9725.
  11. Monnin N, Fattet AJ, Koscinski I. Endometriosis: Update of Pathophysiology, (Epi) Genetic and Environmental Involvement. Biomedicines. 2023 Mar 22;11(3):978. DOI: 10.3390/biomedicines11030978
  12. Carp JA, Soriano D, Zolti M. Progestogens and endometriosis. Progestogens in obstetrics and gynecology. 2015:129–47
  13. Horie S, Harada T, Mitsunari M, et al. Progesterone and progestational compounds attenuate tumor necrosis factor alpha-induced interleukin-8 production via nuclear factor-kappa B inactivation in endometriotic stromal cells. Fertil Steril. 2005 May(5);83:1530–5. DOI: 10.1016/j. fertnstert.2004.11.042
  14. Reis FM, Petraglia F, Taylor RN. Endometriosis: hormone regulation and clinical consequences of chemotaxis and apoptosis. Hum Reprod Update. 2013 Jul-Aug;19(4):406–18. DOI: 10.1093/humupd/dmt010
  15. Schweppe K-W. The place of dydrogesterone in the treatment of endometriosis and adenomyosis. Maturitas 2009 Dec;65 (Suppl 1):23–7. DOI: 10.1016/j.maturitas.2009.11.011
  16. Schindler AE, Campagnoli C, Druckmann R, et al. Classification and pharmacology of progestins. Maturitas 2003 Dec;46(Suppl 1):7–16. DOI:10.1016/j.maturitas.2003.09.014
  17. Sukhikh GT, Adamyan LV, Dubrovina SO, et al. Prolonged cyclical and continuous regimens of dydrogesterone are effective for reducing chronic pelvic pain in women with endometriosis: results of the ORCHIDEA study. Fertil Steril. 2021 Dec;116(6):1568–77
  18. Kitawaki J, Koga K, Kanzo T, Momoeda M. An assessment of the efficacy and safety of dydrogesterone in women with ovarian endometrioma: An open-label multicenter clinical study. Reprod Med Biol. 2021 Jun 4;20(3):345-51. DOI: 10.1002/rmb2.12391
  19. Bahat PY, Yücel B, Yuksel Ozgor BY, et al. The effect of dydrogesterone on sexual function in endometriosis. J Obstet Gynaecol. 2021 Sep 28:1–4. DOI: 10.1080/01443615.2021.1958765.
  20. Татарчук ТФ, Калугіна ЛВ, Данилова АО, Павлова КС. Комплексний підхід до лікування больового синдрому при аденоміозі. Репродуктивна ендокринологія. 2021 59:53–60 DOI:
  21. NICE. Endometriosis: Diagnosis and management [Internet]. NICE guideline [NG73]; 2017 Sep. Available from:
  22. Lukas I, Kohl-Schwartz A, Geraedts K, et al. Satisfaction with medical support in women with endometriosis. PLoS One. 2018 Nov 29;13:e0208023. DOI: 10.1371/journal.pone.0208023.
  23. Bernuit D, Ebert AD, Halis G, Strothmann A, Gerlinger C, Geppert K, et al. Female perspectives on endometriosis: findings from the uterine bleeding and pain women’s research study. J Endometriosis. 2011 Oct 6;3(2):73–85. DOI: 10.5301/JE.2011.8525.
  24. Chapron C, Souza C, Borghese B, et al. Oral contraceptives and endometriosis: the past use of oral contraceptives for treating severe primary dysmenorrhea is associated with endometriosis, especially deep infiltrating endometriosis. Hum Reprod. 2011 Aug;26(8):2028–35. DOI: 10.1093/humrep/der156
  25. Schindler AE. Progestational effects of dydrogesterone in vitro, in vivo and on the human endometrium. Maturitas 2009 Dec:65 Suppl 1:S3–11. DOI: 10.1016/j.maturitas.2009.10.011
  26. Techatraisak K, Hestiantoro A, Soon R, et al. Impact of Long-Term Dienogest Therapy on Quality of Life in Asian Women with Endometriosis: the Prospective Non-Interventional Study ENVISIOeN. Reprod Sci. 2022 Apr;29(4):1157–69. DOI:10.1007/s43032-021-00787-w
  27. Barra F, Scala C, Maggiore LRU, Ferrero S. Long-Term Administration of Dienogest for the Treatment of Pain and Intestinal Symptoms in Patients with Rectosigmoid Endometriosis. J Clin Med. 2020 Jan; 9(1):154. DOI:10.3390/jcm9010154
  28. Nirgianakis K. Vaineau C, Agliati L, et al. Risk factors for non-response and discontinuation of Dienogest in endometriosis patients: A cohort study. Acta Obstet Gynecol Scand. 2021 Jan;100(1):30-40. DOI: 10.1111/aogs.13969
  29. Kim SE, Lim H, Lee D, Choi D. TheLong-Term Effect of Dienogest on Bone Mineral Density After Surgical reatment of Endometrioma. Reprod Sci. 2021 May;28(5):1556-1562. DOI: 10.1007/s43032-020-00453-7
  30. Rižner TL, Brožič P, Doucette C, et al. Selectivity and potency of the retroprogesterone dydrogesterone in vitro. Steroids. 2011 May; 76(6): 607-615. DOI:10.1016/j. steroids.2011.02.043
  31. Practice Committee of the American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertil Steril 2014 Apr;101(4):927–935. DOI: 10.1016/j.fertnstert.2014.02.012
  32. Instructions for the medical use of the drug Dufaston® dated 06/22/2022.
  33. Kim SA, Kim SJ, Um MJ, et al. Effects of dienogest for dysmenorrhea associated with endometriosis. Gynecol Endocrinol. 2016, suppl.1 (32): 108.



How to Cite

Boichuk, A., Herman, D., Dubossarska, Y., Zakharenko, N., Kalugina, L., Kosei, N., Reheda, S., Rozhkovska, N., Tatarchuk, T., Trokhymovich, O., Yashina, O., & Yarotska, N. (2023). Resolution of the First Ukrainian endometriosis forum “Drug treatment for endometriosis-associated pelvic pain. The quality of a woman’s life”. REPRODUCTIVE ENDOCRINOLOGY, (70), 8–14.