( S ) Few studies of medical therapies for endometriosis report outcomes that are relevant to patients , and many women gain only limited or intermittent benefit from treatment
OBJECTIVE To assess patient response rates to medical therapies used to treat endometriosis-associated pain .
Low-dose add-back therapy during postoperative GnRH agonist treatment.
OBJECTIVE Low-dose add-back therapy during postoperative GnRH agonist treatment could lower the risk of add-back-induced endometriosis recurrence and reduce treatment dropout compared with a regular dose . However , the effect of low-dose add-back therapy is still unknown . The aim of this study was to determine whether low-dose add-back therapy can also effectively relieve the hypoestrogenic side effects and simultaneously maintain a therapeutic response of GnRH agonist treatment . MATERIAL S AND METHODS This analysis was a prospect i ve cohort study . During postoperative GnRH agonist treatment , a total of 107 women were prescribed add-back therapy [ oral combination tablet ; estradiol valerate ( 1 mg ) and medroxyprogesterone acetate ( 2.5 mg ) ] ( Indivina ; Orion , Espoo , Finl and ) for 20 weeks . Patients in the low dose add-back therapy group were prescribed the tablet once a day , and patients in the regular dose group were given the tablet twice a day . Hypoestrogenic side effects , such as hot flashes and insomnia , were recorded . Patients were also question ed regarding their pelvic symptoms and pain to evaluate the possibility of endometriosis recurrence . Lumbar spine ( L2-L4 ) bone mineral density was measured using dual X-ray absorptiometry . The dropout rates in both groups were also evaluated . RESULTS The incidence of hypoestrogenic side effects was lower in the low dose group compared with the regular dose group , including hot flashes ( 19.2 % vs. 21.8 % , p = 0.741 ) and insomnia ( 15.4 % vs. 18.2 % , p = 0.699 ) , although there were no significant difference between the groups . In addition , a higher number of patients in the regular dose group dropped out of treatment compared to the low dose group ( 14.5 % and 9.6 % , respectively , p = 0.435 ) . The patients in both groups had a significant loss of mean bone mineral density during therapy ( p < 0.001 and p = 0.018 for the low dose and regular dose groups , respectively ) . CONCLUSION Low dose add-back therapy could effectively ameliorate hypoestrogenic side effects and simultaneously maintain the therapeutic response of GnRH agonist treatment . The treatment dropout was lower compared with a regular dose . Therefore , low dose add-back therapy can be considered a treatment choice during postoperative GnRH agonist treatment
( S ) Few studies of medical therapies for endometriosis report outcomes that are relevant to patients , and many women gain only limited or intermittent benefit from treatment
OBJECTIVE To assess patient response rates to medical therapies used to treat endometriosis-associated pain .