Potential of an Ethinyl Estradiol 30 mcg/Dienogest 2 mg Combination to Treat Women with Endometrial Hyperplastic Changes in Uterine Body Associated with Other Abnormalities
Study Objective: To assess the effectiveness of combined oral contraceptive (COC) Siluette (Gedeon Richter), containing ethinyl estradiol 30 mcg/dienogest 2 mg, in treating endometrial hyperplastic conditions associated with adenomyosis during the menopause transition. Materials and Methods: The authors examined 108 patients, aged 41 to 45, who were suffering from recurrent endometrial hyperplasia (EH) associated with adenomyosis of varying intensity. Atypical EH was found in 17 (15.7%) patients, and they were excluded from further study. Clinical, morphological, and immunohistochemical parameters were monitored at baseline and during treatment with COC. In addition to conventional methods, the authors used immunohistochemistry to investigate the expression of receptors to sex steroid hormones (ER-a and PR), and expression of cellular proliferation markers. Study Results: The study showed that after 6 months of treatment with the study drug, 96.6% of patients no longer had any morphological signs of EH. In addition, 3.4% of patients had several foci of hyperplastic endometrium that were histologically classified as simple non-atypical EH. Immunohistohemistry showed that a 6-month course of COC, containing ethinyl estradiol 30 mcg/dienogest 2 mg, significantly reduced ER-a and PR expression, both in the glandular epithelium and in the endometrial stroma. Conclusion: The study results suggest that the use of COC, containing ethinyl estradiol 30 mcg/dienogest 2 mg, to treat endometrial hyperplastic conditions associated with adenomyosis during pre-menopause can be considered research-based.