( 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 .
Administration of nasal nafarelin as compared with oral danazol for endometriosis. A multicenter double-blind comparative clinical trial.
Treatment with nafarelin , a gonadotropin-releasing hormone agonist , reversibly inhibits ovarian function and induces hypoestrogenemia . To determine the efficacy of such hormonal manipulation in the treatment of endometriosis , we r and omly assigned 213 patients with laparoscopically confirmed endometriosis to receive , for six months , either nafarelin by nasal spray ( 400 or 800 micrograms per day ) or oral danazol ( 800 mg per day ) . Placebo nasal spray and placebo tablets were used to double blind the study . Pretreatment and post-treatment laparoscopies were compared by means of the American Fertility Society 's scoring system . More than 80 percent of the patients in each treatment group had a reduction in the extent of disease as assessed by laparoscopy . The mean laparoscopic scores decreased from 21.9 to 12.6 with 800 micrograms of nafarelin , from 20.4 to 11.7 with 400 micrograms of nafarelin , and from 18.4 to 10.5 with danazol ( P = 0.0001 within each group ; there were no statistically significant differences between the groups ) . The percentage of women with severely painful symptoms of endometriosis decreased from about 40 percent to 5 to 10 percent , whereas the percentage with no or minimal discomfort rose from 25 to 70 percent . Of the 149 patients who tried to become pregnant , 58 ( 39 percent ) succeeded after the completion of treatment ; similar rates of pregnancy applied to the three treatment groups . Danazol use decreased high-density lipoprotein levels and increased low-density lipoprotein levels . These changes were not observed in nafarelin users , but a higher percentage of them reported hot flashes and decreased libido . We conclude that nafarelin is an effective agent for treating endometriosis and has few side effects other than hypoestrogenism
( 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 .