WhelWomen's Health Evidence Lab
WHEL-C-060 · Strong evidence · 9/10

DIENOGEST for adenomyosis

Two meta-analyses indicate dienogest substantially alleviates dysmenorrhea and pelvic pain and reduces uterine volume in women with adenomyosis, with superiority over LNG-IUS for pain and uterine volume.

Origin · ApprovedPathway · 505(b)(2) · existing active ingredient, new indicationEvidence arm · Direct researchEvidence supports
How to read thisThe summary above and the proposed mechanism are generated by the model from the sources it ingested, and are written as the model’s reasoning rather than established fact. Any figure quoted from MATRIX is a model-derived association score, not a clinical measurement. How far the published record backs this pair is carried by the score’s own rigor dimension and traced to verbatim sources at the foot of the page.

Hypothesized mechanism

As a progestin, dienogest may suppress adenomyotic tissue activity, reducing pelvic pain and uterine volume.

This is the model’s proposed mechanism from the sources on file, not a demonstrated causal pathway. How well the published record supports it is reflected in the rigor and plausibility dimensions of the score, and traced to the verbatim sources at the foot of the page.

How the score was reached, for this pair

The composite score is the sum of five dimensions, each scored 0 to 2 by the model from the evidence on file. Below is the sub-score this specific pair received on each, with what that dimension measures. It scored 9 of 10 overall, a strong reading, from a direct rated strong in strength.

The model’s overall reasoning for this pair is the summary at the top of the page, and the mechanism it proposed is in the section above.

Pathway arm0.0 / 10 · Exploratory

Scored for women. Female representation not stated — applicability to women uncertain (flagged for full text). (band F4, ×0.75).

Corroboration

Only a single claim is provided, sourced from Open Targets noting DIENOGEST as a Phase 1 clinical candidate for adenomyosis. No mechanistic lines of evidence are described, so no independent convergence can be assessed.

0 / 2

Rigor

The claim is a database registry entry indicating clinical-candidate status, not a mechanistic model or study. No human-relevant or in-vitro mechanistic data are presented.

0 / 2

Specificity

The claim identifies DIENOGEST as a small molecule candidate but names no molecular target or mechanism of action. Without target information, drug-target specificity cannot be scored.

0 / 2

Plausibility

No target-phenotype relationship is described in the single claim. The entry only states clinical-candidate status, providing no basis to evaluate mechanistic plausibility.

0 / 2

Consistency

With only one registry claim and no mechanistic signals, there is nothing to compare for directional consistency.

0 / 2
Direct research arm · anchors the headline9.0 / 10 · Strong

Scored for women. Evidence generated in women (female population, ~100% female). (band F1, ×1.00).

Corroboration

Evidence comes from two independent systematic reviews/meta-analyses (Dienogest in-depth meta-analysis and the LNG-IUS comparison meta-analysis), both consistently finding dienogest effective for adenomyosis. Two distinct syntheses agreeing in direction supports a high score, though neither is a single large RCT.

2 / 2

Rigor

Both sources are explicitly meta-analyses (claims 1-12 cite 'meta-analysis' and 'systematic review and meta-analysis'), the highest study-design tier.

2 / 2

Specificity

Claims name both dienogest and adenomyosis directly (e.g., 'Dienogest substantially alleviates dysmenorrhea in women with adenomyosis' and 'more effective than LNG-IUS for the management of adenomyosis').

2 / 2

Plausibility

The claims describe outcomes (reduced pelvic pain, reduced uterine volume) consistent with a progestin acting on adenomyotic tissue, but no explicit mechanism is stated in the quotes. Mechanistic plausibility is implied rather than evidenced.

1 / 2

Consistency

Both independent meta-analyses agree dienogest is effective and reduces dysmenorrhea/pelvic pain; the comparison review further shows superiority over LNG-IUS for pain and uterine volume. The only negative (lower haemoglobin) is a safety signal, not a contradiction of efficacy.

2 / 2
How the scoring rubric works, in general

Independent reading, reported beside the score

One outside model cross-reference is reported alongside the composite score. It is recorded separately and is not combined into the score.

MATRIX cross-reference

Every Cure’smachine-learned treatment-probability model, drawn from a biomedical knowledge graph across roughly 1,800 drugs and 22,000 diseases. It provides a model-based estimate of how plausible a drug-disease link is given the structure of biomedical knowledge, reported alongside the substrate’s own evidence.

For this pair. MATRIX maps this drug and disease in its graph but returned no treat-score for the pair, which can mean the predicted link fell below the model's publication threshold.

Scored over MATRIX’s own entities, confirming the same drug and disease: CHEBI:70708 (drug) and MONDO:0010888 (disease). Validate against the source: Every Cure’s MATRIX dataset ↗.

More on the MATRIX cross-reference and its provenance

Layers not covered for this pair

Sex-specific pharmacokineticsNone on file

Not covered for this pair. This layer holds documented sex-specific pharmacokinetics for a limited set of drugs, and this compound is not among them yet. A blank here means the drug is not covered by the layer, not that no sex difference exists.

More on the sex-specific pharmacokinetics layer and its sources
Cycle-phase dependenceNone on file

Not covered for this pair. The cycle-phase layer is seeded for the strongest-evidence cases so far (PMDD), and this pair is not among them yet. A blank here means the pair is not covered by the layer, not that the effect was found to be phase-independent.

More on the cycle-phase layer and its sources

Source evidence · what the pipeline ingested

These are the sources the pipeline ingested to detect and score this signal, the published literature the model actually read, each tagged by study type. Where the model combined findings the claim is marked as a synthesis (S), and where the literature disagrees the contradiction is shown (!).

Every source below belongs to this signal’s evidence arm, Direct research. Whel reads each drug-condition pair through four such arms, each held to its own inclusion bar; a signal is surfaced through one of them.

These are the verbatim sources the pipeline surfaced and read; they may not be the full published record for a pair, and the score reflects the strength and agreement of the evidence rather than its volume. The strength of these source types is what the rigor dimension of the score reads off. MATRIX, sex-specific pharmacokinetics, and cycle phase are separate layers the pipeline does not ingest, external cross-references reported beside the score, and they link to their own sources in their sections above.

The primary sources and pipelines this evidence is drawn from