Jakarta, IO – Endometriosis affects 10% of women of reproductive age worldwide. In Indonesia, five out of 100 women of childbearing age suffer from endometriosis, resulting in high rates of morbidity, absenteeism, and socio-economic costs, while adversely affecting the quality of life, due to its high recurrence rate, of up to 67%. The stigma associated with endometriosis, including that abdominal or pelvic pain will disappear after having children, makes a lot of women reluctant to seek treatment, and is a factor in delays in diagnosis of between 6 and 8 years.
“Endometriosis is a chronic, progressive disease that is influenced by the hormone estrogenic, in the form of tissue growth outside the uterus that causes excessive pain or tenderness. This tissue thickens, breaks down, and bleeds with each menstrual cycle. Risk factors are never having given birth, early menstruation, late menopause, short menstrual cycle (maximum 27 days), or high estrogenic levels. Other symptoms, such as bloating, difficulty defecating, and getting tired easily were also mentioned by 40% of patients,” said Dr. dr. Kanadi Sumapraja, Sp.OG, Subsp.FER, MSc., specialist obstetrician and gynaecologist who is also a teaching staff at Faculty of Medicine University Indonesia, in a media briefing with the theme “Long Term Dienogest Therapy is a Strong Recommendation for Endometriosis Treatment” which was held in Jakarta, Friday (8/3/2024).
Apart from menstrual pain (dysmenorrhea), symptoms of endometriosis include pain during sexual intercourse (dyspareunia), pain when urinating (dysuria), pain when defecating (dysphasia), lower abdominal pain, and pelvic pain. Generally, patients complain of a throbbing pain that spreads to the legs, pain in the rectum, and a sensation of the stomach being pulled downwards. Endometriosis is grouped into peritoneal endometriosis (superficial), ovarian cysts (ovarian endometriosis), and deep infiltrating endometriosis (DIE).
“Endometriosis therapy requires long-term hormonal treatment. The key to successful treatment is compliance. Many patients stopped treatment halfway because they felt there was no improvement in their disease. Those whose treatment is non-compliant (on-off) will experience relapses more often. Currently, progestin therapy in the form of a 2 mg daily dose of Dienogest is the first line of therapy, because of its safety and effectiveness profile. Again, hormonal treatment will be effective if there is adherence to long-term treatment,” he said.
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Low VAS
Meanwhile, Dr. Dewi Muliatin Santoso, Head of Medical Dept. Pharmaceuticals Bayer Indonesia, explained that Dienogest hormonal therapy showed a 40% reduction in pain within 4 weeks of use. “In addition, in a study of 29 patients undergoing Dienogest therapy, more than 80% experienced endometriosis cell loss by the 24th week of treatment. Long-term real-world evidence shows that Dienogest can maintain a low Visual Analog Scale (VAS or parameter for measuring the degree of pain in endometriosis) for 5 years. The Envisioen study also proved that the bleeding patterns experienced by patients decreased over time. Compliance with taking medication will have a positive impact,” she explained.
On the same occasion, Wenny Aurelia, Founder of Endometriosis Indonesia, said that the Endometriosis Indonesia community was founded as a forum for discussing and disseminating correct information about endometriosis. “We also provide support to patients so that they do not feel alone in fighting this disease,” said Wenny. (est)
