Visanne (Dienogest)
A once-daily progestogen tablet made for endometriosis. As good as hormone shut-down implants for pain, with far fewer menopause-type side effects.
Quick answer: Visanne is a 2 mg dienogest tablet taken every day without a break to treat endometriosis pain. In trials it worked as well as GnRH agonists (like Zoladex) for pain, with fewer hot flushes and less bone loss. Irregular bleeding or spotting is common in the first months. It isn’t on the PBS, so it’s a private script. Use condoms or another non-hormonal method for contraception.
At a glance
- For
- Endometriosis pain
- Works
- Reduces pelvic pain for most; similar to GnRH agonists in head-to-head trials
- Cost
- Not on the PBS: a private script, with price varying by pharmacy
- Kicks in
- Pain usually eases over 1–3 months
- Dose
- One 2 mg tablet daily, continuously, at the same time each day
- Watch for
- Spotting or irregular bleeding, headache, breast discomfort, low mood, acne, weight change
A calmer alternative to a chemical menopause. The spotting is annoying but usually settles; low mood is the side effect to watch.
Brand names
- Visanne, and generic dienogest brands
How it works
Dienogest is a progestogen that thins endometriosis tissue, reduces its inflammation and new blood vessels, and partly lowers oestrogen without dropping it to menopausal levels.
Used for
- Endometriosis (TGA-approved), including after surgery to reduce recurrence
- Often a first or second choice when the combined pill or other progestogens haven’t helped enough
Side effects
Irregular bleeding or spotting is the most common side effect, especially in the first 3 months, and usually improves. Headache, breast discomfort, low mood, acne, hair thinning and weight gain are also common. Bone density can fall slightly in teenagers.
Full side-effect list (from the product information)
How often, from the official product information. Bold = serious.
Common 1 in 10 to 1 in 100
- Spotting or irregular bleeding (very common early on)
- Headache or migraine
- Breast discomfort
- Low mood, mood swings or poor sleep
- Lower libido
- Acne or hair loss
- Weight gain
- Hot flushes
- Nausea or tummy pain
- Ovarian cysts (usually harmless)
- Tiredness
Uncommon 1 in 100 to 1 in 1,000
- Anxiety
- Vaginal discharge or dryness
- Itch or rash
- Anaemia from heavy bleeding
- Back pain
Rare 1 in 1,000 to 1 in 10,000
- Blood clots (no proven extra risk, but stop and seek help with symptoms)
Get help urgently if
- One-sided calf swelling or pain, sudden breathlessness or chest pain. Call 000
- Very heavy bleeding
- Severe low mood or thoughts of self-harm. Call Lifeline 13 11 14
- Sudden severe headache or vision changes
Good to know
- Contraception: it usually stops ovulation but isn’t approved as a contraceptive. Use condoms or a copper IUD.
- Teenagers: bone density may fall a little; your doctor will weigh this up.
- Low mood: tell your doctor early if mood drops, especially with a past history of depression.
- Some medicines (e.g. some epilepsy medicines, rifampicin, St John’s wort) make it less effective.
- Missed a tablet? Take it as soon as you remember, then carry on.
Common questions
How long does Visanne take to work?
Pain usually eases over 1–3 months. Spotting is common at first and tends to settle with time.
Is Visanne a contraceptive?
No. It usually stops ovulation, but it isn’t approved as a contraceptive, so use condoms or a copper IUD.
Is Visanne on the PBS?
No. In Australia it’s a private prescription, and the price varies by pharmacy and brand.
Information only. Not a recommendation or endorsement of any product. Whether a medicine suits you depends on your health and other medicines, so talk to your doctor or pharmacist. In an emergency, call 000 (Australia) or your local emergency number. From a mobile, 112 works in most countries.
More information
- Visanne product information (TGA)
- Strowitzki T et al. Dienogest vs leuprolide acetate in endometriosis (2010, Human Reproduction)
- Endometriosis Australia
- Healthdirect: Medicines information
maladywise.com/medicines/dienogest/