Dienogest, commonly used for endometriosis and in combination with estradiol for contraception, is generally well-tolerated but may cause a range of side effects, from mild to serious.[4] The most frequently reported adverse effects include changes in menstrual bleeding patterns, such as abnormal uterine bleeding (up to 55% of users), and amenorrhea (absence of menstruation) in about 17% of users.[5] Swelling (peripheral edema) occurs in approximately 13% of patients.[5]
Other common side effects include:
- Light vaginal bleeding or spotting
- Nausea, especially during the first few months
- Breast pain or tenderness
- Weight gain
- Headache and migraine
- Irregular menstrual periods
- Vomiting
- Problems with contact lenses
[1][3][4]
Less common or rare side effects may include:
- Lower abdominal pain
- Dysmenorrhea (painful periods)
- Dyspepsia (indigestion)
- Urticaria (hives)
- Diarrhea
- Back pain
- Anemia
[3][5][7]
Serious but uncommon adverse effects can occur, including:
- Allergic reactions (hives, swelling of face/lips/tongue/throat, difficulty breathing)
- Blood clots (symptoms like chest pain, shortness of breath, swelling or warmth in the legs)
- Stroke and heart attack symptoms (sudden weakness or numbness, slurred speech, chest pain)
- Liver problems (persistent stomach pain, dark urine, yellowing of the skin/eyes)
- Severe pelvic pain or unexplained migraine changes
- Breast lumps
- Depression (sleep problems, mood changes, tiredness)
- Decreased lumbar spine bone mineral density (with long-term use)
- Hemorrhagic shock (extremely rare)
[1][3][5][7]
Users should always report unusual or severe symptoms to their healthcare provider.[1]
References
- [1] Dienogest and estradiol Uses, Side Effects & Warnings – Drugs.com
- [3] Dienogest / Estradiol Side Effects: Common, Severe, Long Term
- [4] Dienogest – Wikipedia
- [5] A systematic review and Bayesian analysis of the adverse effects of dienogest
- [7] A systematic review and Bayesian analysis of the adverse effects of dienogest – PubMed