Comparative study of quality of life between endometriosis patients receiving GnRH agonist and dienogest therapy: A cross-sectional study using Endometriosis Health Profile-30 (EHP-30)

Abstract

Endometriosis is a chronic gynecological disease that substantially impairs quality of life. Gonadotropin-releasing hormone (GnRH) agonists and dienogest are commonly used hormonal therapies for endometriosis; however, direct comparisons of their effects on quality of life remain limited. This study aimed to compare quality of life between patients with endometriosis receiving GnRH agonist and dienogest therapy using the Endometriosis Health Profile-30 (EHP-30). A comparative cross-sectional study was conducted among 100 patients with endometriosis at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia, comprising 50 patients receiving GnRH agonist therapy and 50 receiving dienogest therapy. Quality of life was assessed using the Indonesian version of the EHP-30, with higher scores indicating poorer quality of life. Between-group comparisons and multiple linear regression were performed. Patients receiving dienogest had significantly lower total EHP-30 scores than those receiving GnRH agonist therapy (20.1±9.6 vs 43.7±14.9; p<0.001). Significantly lower scores were also observed in all EHP-30 core domains and optional modules in the dienogest group (all p<0.001), with the largest differences observed in pain, control and powerlessness, and emotional well-being. In multivariable analysis, dienogest therapy remained independently associated with a lower total EHP-30 score after adjustment for demographic and clinical factors (β=−23.625; 95%CI: −28.803 to −18.447; p<0.001). This study highlights that dienogest therapy was associated with better quality of life than GnRH agonist therapy among patients with endometriosis. These findings support the consideration of dienogest as a patient-centered hormonal option when quality of life is a major treatment priority.