Dienogest was synthesized in 1979 in Jena , Germany under the leadership of Prof. Kurt Ponsold, was initially referred to as STS-557 .   It was found that its potency was 10 times that of levonorgestrel .  The first product on the market to contain dienogest was a combined oral contraceptive pill (with ethinylestradiol), Valette, introduced in 1995 and made by Jenapharm .  In 2007, dienogest was introduced as Dinagest in Japan for the treatment of endometriosis, and it was subsequently marketed for this indication as Visanne in Europe and Australia in December 2009 and April 2010, respectively.  Qlaira was introduced in Europe in 2009 and Natazia was introduced in the United States in 2010. 
Clinical practice guidelines recommend > 3400 anti-factor Xa International Units of LMWH subcutaneous daily (equivalent to > 34 mg subcutaneous daily of enoxaparin). For most patients, continue prophylaxis until hospital discharge; however, in patients that are considered to be at high risk (., > 60 years of age or a history of VTE), continue prophylaxis through hospitalization and for 2—4 weeks after discharge. Previous guidelines have suggested a dose of enoxaparin 40 mg subcutaneous 1—2 hours before surgery then daily or 30 mg subcutaneous every 12 hours starting 8—12 hours before surgery.