ObjectiveTo investigate the therapeutic efficacy of dienogest in childbearing-age patients with recurrent endometriosis after conservative surgical treatment.MethodsA total of 81 patients who were admitted to our hospital due to recurrent endometriosis after laparoscopic surgery from January 2020 to December 2022 were selected and randomly divided into a study group and a control group. The study group received oral dienogest at a dose of 2 mg once daily, which could be started at any time during the menstrual cycle, with a treatment duration of 24 weeks. The control group was subcutaneously injected with gonadotropin-releasing hormone analogue (GnRH-a) of 3.75 mg on the first day of the menstrual cycle, once every 28 days, for a total of 24 weeks. Low-dose estrogen (0.5 mg/d) was given at the 18th week of treatment (regardless of the occurrence of hot flashes) or when experiencing uncomfortable symptoms such as hot flashes. The levels of follicle-stimulating hormone (FSH) and estradiol (E2) before and after treatment were compared between the two groups to evaluate the hormonal suppression. The levels of CA125 and the size of the cysts before and after treatment were compared to assess the disease control. Pain was evaluated using the Visual Analog Scale (VAS), and the pain reduction index (X) was used to assess the quality of life of the patients. The adverse reactions and the recurrence of dysmenorrhea after discontinuation of the medication were assessed.ResultsThere were 40 patients in the study group with a mean age of (42.00±3.84) years and a mean recurrence time of (16.00±4.42) months. There were 41 patients in the control group with a mean age of (45.00±1.96) years and a mean recurrence time of (14.00±3.88) months. There were no statistically significant differences in the levels of FSH, E2, or CA125 between the two groups before treatment, at 6 months of treatment, or at 6 months after treatment (all P>0.05). Transvaginal ultrasound showed that the cyst size was (7.37±2.40) cm³ in the study group and (7.39±2.14) cm³ in the control group before treatment (P>0.05). The cyst size decreased after treatment in both groups, but there was no significant difference in the cyst size between the two groups (P>0.05). There were no statistically significant differences in VAS scores between the two groups before treatment, at 6 months of treatment, or at 6 months after treatment (all P>0.05). The VAS scores at 6 months of treatment and at 6 months after treatment were significantly lower than those before treatment in both groups (all P<0.05). In the study group, the complete relief of pain was achieved in 28 patients, significant relief in 11, and partial relief in one; in the control group, 32 patients achieved complete relief of pain, and 9 had significant relief. The total effective rate of treatment was 100.00% in both groups (P>0.05). During the treatment period, 17 patients in the study group experienced irregular vaginal bleeding, while only 3 patients in the control group (P<0.05). Six patients had hot flashes and the symptom relieved after administration of estrogen in the control group, while no patient in the study group experienced such symptoms (P<0.05). The dysmenorrhea recurred in one patient in the study group and 3 patients in the control group (P>0.05). Follow-up results at 6 months after discontinuation of the medication showed no significant change in the cyst volume at 6 months after treatment as compared to that at 6 months of treatment in either group, and there was no statistically significant difference in cyst volume between the two groups at 6 months after treatment (P>0.05).ConclusionDienogest is safe and effective in the treatment of recurrent endometriosis in women of childbearing age and is suitable for long-term management of such patients.