Risk factor analysis of abnormal uterine bleeding in patients with adenomyosis treated with dienogest

LIANG Yuan-qi; LIANG Xiao-ru; WANG Jun-ling; XIANG Dong-fang

doi:10.13820/j.cnki.gdyx.20243052

Abstract：Objective To explore the clinical characteristics of abnormal uterine bleeding(AUB)in patients with adenomyosis treated with oral dienogest,analyze potential risk factors,and establish a predictive model to provide clinical recommendations for the use of dienogest.Methods Female patients with adenomyosis treated with oral dienogest at the gynecology outpatient clinic of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2022 to December 2023 were included.Clinical data and information on abnormal uterine bleeding were retrospectively collected.Patients were categorized into an abnormal bleeding group and a non-abnormal bleeding group based on post-treatment uterine bleeding patterns.Univariate analysis was conducted,and binary multivariate logistic regression was used to identi-fy risk factors for AUB and construct a predictive model.The model's performance was evaluated using ROC and calibra-tion curves.Results Among 190 patients taking oral dienogest,the incidence of abnormal uterine bleeding was relatively high(37.89％).Multivariate logistic regression identified uterine volume,endometrial thickness,and dysmenorrhea VAS score as significant risk factors for AUB(all P＜0.05).A predictive model was developed with an area under the ROC curve(AUC)of 0.856(95％CI:0.801-0.856).Conclusion This study provides clinical recommendations for the use of dienogest.Initiating medication during the early proliferative phase of the menstrual cycle may reduce the risk of ab-normal uterine bleeding.Patients with larger uterine volume and severe dysmenorrhea should be closely monitored for this adverse effect when using dienogest.