Severe dysmenorrhea, normal MRI/ultrasounds, and Visanne — looking for long-term experiences

I’m 18 and I’ve had severe menstrual pain for several years. My periods were extremely painful and could interfere with my everyday life and tennis training. I’m a competitive tennis player, so having symptoms that could affect my ability to train was particularly difficult.

Because of the severity of my symptoms, endometriosis was suspected. I’ve had several pelvic ultrasounds and a pelvic MRI, but they did not show clear evidence of endometriosis. More recently, adenomyosis has also been considered because of some changes seen on ultrasound, but I still don’t have a confirmed diagnosis.

I’ve tried several hormonal treatments, including combined birth control pills. They helped to some extent, but in February 2026 I switched to Visanne (dienogest 2 mg).

The improvement has been significant.

Since starting Visanne, my symptoms have become much more manageable and I no longer have regular menstrual bleeding. For me, as an athlete, not having periods is actually a major benefit, because I no longer have to deal with severe menstrual pain during training or competitions. If my doctor considers it appropriate, I would be comfortable staying on Visanne long-term.

However, I can still feel some degree of cyclical pattern despite not having periods. At certain times I notice changes in how I feel and occasional lower abdominal/pelvic sensations that remind me of what I used to experience before or during my period. They are nowhere near as severe as my previous menstrual pain, but it makes me wonder whether I am still experiencing some hormonal/cyclical changes despite not bleeding.

My biggest question is about the long-term effectiveness of Visanne:

Can Visanne continue controlling symptoms effectively for many years, or can it eventually become less effective?

I would especially love to hear from people who:

• have been taking Visanne/dienogest for 1+ years;
• originally had severe dysmenorrhea;
• had normal or inconclusive ultrasounds/MRI;
• experienced a major improvement after starting Visanne;
• no longer have menstrual bleeding but still notice some cyclical symptoms;
• or had pain or bleeding return after being stable for a long time.

I’m not looking for a diagnosis from Reddit. I’m mainly interested in hearing about long-term personal experiences, especially from people who initially responded very well to Visanne.

If you’ve been taking Visanne long-term: how long have you been on it, does it still work as well as it did initially, and do you still notice any cyclical symptoms despite not having periods?