To observe the clinical efficacy and safety of low-dose mifepristone tablets combined with dienogest tablets in the treatment of ovarian chocolate cyst patients.

Patients with ovarian endometriomas were divided to control group, treated with dinoprost tablets at a dose of 2 mg once daily (qd), while the treatment group received additional low-dose mifepristone tablets at 5 mg qd in addition to the control regimen. Both groups were treated for 6 months. The clinical efficacy, dysmenorrhea symptom scores, hormone levels, carbohydrate antigen 125 (CA125) levels, endometrial thickness, uterine volume, inflammatory factor levels, and safety profiles before and after treatment were compared.

A total of 123 patients were enrolled, with 63 cases in the control group and 60 cases in the treatment group. The treatment group demonstrated a significantly higher overall response rate [91.67% (55 cases/60 cases) vs. 77.78% (49 cases/63 cases), P<0.05]. After treatment, the visual analog scale (VAS) scores of the control group and the treatment group were (2.13±0.67) and (1.78±0.55) points, respectively; the dysmenorrhea symptom scale (CMSS) scores were (21.78±4.19) and (19.86±4.54) points, respectively; the levels of FSH in the control group and the treatment group were (5.06±1.11) and (4.48±1.17) U·L^-1, respectively; the levels of estradiol (E₂) were (204.43±34.68) and (185.73±35.14) pmol·L^-1, respectively; the levels of progesterone (P) were (12.14±2.43) and (10.81±2.29) ng·mL^-1, respectively; the levels of CA125 were (37.31±4.34) and (33.12±4.49) U·mL^-1, respectively; endometrial thickness was (5.88±1.46) and (5.15±1.32) mm, respectively; the uterine volume was (106.15±13.62) and (98.89±11.57) cm³, respectively; the levels of interleukin-6 (IL-6) in the control group and treatment group were (14.38±2.19) and (13.44±2.05) ng·L^-1, respectively; the levels of IL-17 were (8.47±2.08) and (7.56±2.11) pg·mL^-1, respectively; the levels of amyloid A (SAA) were (18.62±2.17) and (17.59±2.13) mg·L^-1, respectively; the recurrence rate was 14.29% (9 cases/63 cases) and 5.00% (3 cases/60 cases), respectively; menstrual restoration time was (46.3±7.1) and (38.5±6.2) d, respectively; the differences of above indicators were all statistically significant compared betwwen two groups (P<0.05, P<0.01). The adverse drug reactions in the control group and the treatment group mainly included headache, breast discomfort, and mild irregular bleeding and the incidence was 9.52% (6 cases/63 cases) in the control group and 11.67% (7 cases/60 cases) in the treatment group (P>0.05).

For patients with ovarian chocolate cysts, low-dose mifepristone tablets combined with dienogest tablets represents a valuable therapeutic strategy, offering enhanced pain relief, hormonal control, and overall efficacy compared to dienogest monotherapy, alongside a comparable safety profile.