Statins: Is it New Weaponry against Endometriosis?

Introduction: Endometriosis is a prevalent female illness linked to infertility and pelvic pain. In vitro studies suggest that statins reduce endometrial stroma growth and hinder angiogenesis. The objectives of this study were to assess if dienogest (DNZ) + atorvastatin (ATV) is more effective than DNZ alone in women with symptomatic endometrioma. Materials and Methods: This prospective comparative study was done in the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh. Women with symptomatic endometrioma were enrolled in the study and were divided into the treatment arm of ATV plus DNZ and the control arm of DNZ alone. To examine the association between Group A (DNZ plus Statin) and Group B (DNZ) regarding the statistical model, a multilevel mixed-effects regression analysis was conducted to evaluate the relationship between the primary exposures, additional independent factors and outcomes such as endometrioma size and pain level. Results: Participants of Group A experienced infertility for more than 3 years than Group B, which was found statistically significant ( P < 0.001). Again, a mixed-level regression analysis was conducted to assess the association between the primary exposure showed that post-intervention, endometrioma size decreased by 0.81 units (95% confidence interval [CI]: −1.10, −0.52, P < 0.001) and pain levels decreased by 3.81 units (95% CI: −4.31, −3.30, P < 0.001). Interestingly, pain levels were 1.64 units higher in the obese group (95% CI: 0.36, 2.92, P = 0.012). Amongst the participants reporting menstrual problems, endometrioma size was reduced by 0.92 units (95% CI: −1.32, −0.52, P < 0.001). Conclusion: The findings revealed that both treatment regimens efficiently lowered the size of endometriomas and relieved discomfort in the study subjects.