Women with endometriosis and adenomyosis report low satisfaction with hormonal therapies, with mood changes emerging as the strongest predictor of dissatisfaction, according to new data presented at the 42nd Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE) in London, UK.
Hormonal therapy remains the cornerstone of treatment for endometriosis and adenomyosis, yet little is known about the factors that influence how patients perceive these treatments beyond pain relief. To address this gap, Robin de Jong and colleagues analysed data from the Dutch arm of the international TEPEA study, examining clinical, treatment-related, and informational factors associated with patient satisfaction.
The nationwide cross-sectional study included 1,191 women aged 16 years and older with self-reported endometriosis, adenomyosis, or both conditions. Participants completed an anonymous online survey between September 2024 and January 2025, assessing hormonal therapy use, side effects, information sources, quality of counselling, and overall treatment satisfaction.
Overall, 93.5% of participants had used hormonal therapy, most commonly combined oral contraceptives or progestogens. However, satisfaction was low, with a mean score of just 2.64 out of 5. More than three-quarters of women (78.4%) had discontinued at least one hormonal therapy because of side effects.
Side Effects Drive Treatment Dissatisfaction
Multivariable analysis identified mood changes, headache, decreased libido, weight gain, younger age, adenomyosis, and use of depot injections, hormonal implants, or hormonal intrauterine devices as independent predictors of lower treatment satisfaction. Among these factors, mood changes and headache showed the strongest association with dissatisfaction.
Better Counselling Associated with Higher Satisfaction
In contrast, women who reported greater satisfaction with the information and counselling provided by healthcare professionals, as well as those who had tried a greater number of hormonal therapies, were more likely to report higher overall satisfaction.
The study also found important differences between diagnostic groups. Satisfaction remained lowest among women with adenomyosis, even after adjustment for other clinical factors. Additionally, 42% of participants reported using complementary or alternative therapies. These women were more likely to rely on non-professional sources of information and reported lower satisfaction both with healthcare-provided information and with hormonal treatment overall.
Among women experiencing vaginal bleeding, discontinuing treatment because of side effects was the strongest predictor of dissatisfaction, alongside mood changes, decreased libido, heavy bleeding, and adenomyosis.
The authors acknowledged several limitations, including self-reported diagnoses, recruitment through patient organisations, and the cross-sectional study design, which precludes conclusions about causality. Treatment satisfaction was also measured using a non-validated questionnaire, and quality-of-life and mental health outcomes were not assessed.
Nevertheless, the findings suggest that improving communication may be as important as optimising treatment itself. The researchers conclude that better counselling, improved evidence-based patient information, and more individualised treatment approaches could enhance satisfaction while reducing reliance on lower-quality online information sources.
Reference
De Jong R et al. Predictors of satisfaction regarding hormonal therapy use in women with endometriosis and/or adenomyosis: Dutch results from the international TEPEA-study. ESHRE Congress 2026, 5-8 July, London.
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