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Reasons for severe pain and nausea while taking Dienogest (Visanne)

Updated: Dec 9, 2025

A woman with endometriosis having sever pain


A client who is undergoing treatment for an ovarian cyst.

- She is currently taking a medication called Dienogest(Visanne)


During her last period (though she wasn't bleeding due to the medication), she was struck by severe lower abdominal pain and nausea, leaving her bedridden.


This was likely due to the medication, but I've researched why this happens and written about it in detail.

If you're interested, please read on.




▼Table of Contents

Reasons for these symptoms while taking dienogest





Reasons for severe pain and nausea while taking Dienogest


There are cases where people experience severe menstrual pain without bleeding. This is particularly common among those taking Dienogest for the treatment of cysts, endometriosis or menopausal hormone therapy.



Why does it happen? There are three main reasons.



  1. The body still remembers the previous menstrual rhythm.

    Dienogest is a medication that suppresses ovulation and the endometrium, but during the first few months, the body may react by thinking, "This is the time of my period," resulting in pain without bleeding.


  1. Peritoneal irritation caused by cysts or adhesion when the tissues around a cyst are irritated, severe lower abdominal pain can lead to nausea and vomiting.

    This is called a vagal reflex, where the pain is so intense that it causes nausea and vomiting.


  2. Autonomic nervous system disorders caused by low estrogen

    When estrogen levels decrease due to the effects of dienogest, the following symptoms may occur:

    -Decreased blood flow

    -Increased pain sensitivity

    -Decreased digestive function

    -Instability in thermoregulation


    These symptoms may lead to a physical condition that worsens pain and nausea.




The key support


Womb balance therapy® support alleviate symptoms

The key support I provide for this condition is:

  1. Approaching the sacrum and lower back to release tension (increasing blood flow in the pelvis)

  2. Diaphragm release (stabilizing the vagus nerve and reducing nausea)

  3. Releasing deep abdominal tension (ovarian line and iliopsoas muscles)

  4. Supporting the liver and spleen (reducing inflammation and vomiting)



    In particular, the combination of "coldness + deep stiffness + shallow breathing" is likely to cause severe pain.




Summary


"Severe pain and nausea without bleeding" during Dienogest often occurs due to a combination of menstrual-like inflammatory reactions, peritoneal irritation, and autonomic nervous system disorders.


While this condition is thought to be not dangerous, it places a great strain on the body. Womb Balance Therapy® can help improve blood circulation throughout the body and alleviate the symptoms.



 
 
 

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