goserelin and Uterine-Hemorrhage

Topics: Adjuvants, Pharmaceutic; Adult; Antineoplastic Agents, Hormonal; Drug Therapy, Combination; Endometriosis; Female; Gonadotropin-Releasing Hormone; Goserelin; Humans; Leiomyoma; Premenstrual Syndrome; Uterine Hemorrhage

GnRH agonists, applied for a long period of time or as depot forms, lead to blocking of gonadotropin and ovarian steroid synthesis. We used their property to induce amenorrhea for treating menorrhagic and menometrorrhagic bleeding in adolescence caused by inborn aplastic and hypoplastic anaemia. In patients with uterine bleeding during the first regular menstrual period or recurring during menstrual periods Zoladex (depot GnRH agonist) has been applied, resulting in stop of bleeding in 2 to 4 days. The drug-induced amenorrhea provides the possibility for physiologic restoring of hemoglobin levels, improvement of therapeutic results from adjuvant antianaemic therapy. Thus a more favourable basis for treating of the main disorder is being created. When surgery is indicated, GnRH agonists provide the opportunity for planning of operating management or for laser ablation of endometrium.

Topics: Acute Disease; Adolescent; Anemia, Aplastic; Delayed-Action Preparations; Female; Gonadotropin-Releasing Hormone; Goserelin; Humans; Uterine Hemorrhage

Seventy patients with stage III or IV endometriosis were randomly assigned to 2 groups after conservative surgery. Group O (n = 35) received 3 cycles of a 28-day gonadotropin-releasing hormone agonist (GnRH-a) treatment (goserelin, 3.6 mg) starting 3-5 days postoperatively. Group M (n = 35) received the same treatment starting on days 1-5 of menstruation. Groups were further subdivided according to add-back treatment. Pre- and posttreated levels of estradiol (E2 ), follicle stimulating hormone (FSH), and luteinizing hormone (LH) and visual analog scale (VAS), Kupperman menopausal index (KMI), and bone mineral density (BMD) scores were recorded. The incidence of uterine bleeding was assessed. In both groups, serum levels of E2 , FSH, and LH and VAS scores decreased significantly after treatment. Spotting was the most frequent bleeding pattern. During cycle 1, the bleeding time in group M was much longer that than that in group O (P =.001), and the bleeding rate in group M was significantly higher than that in group O (P =.024, RR = 1.185). In patients with stage III or IV endometriosis, the efficacy of GnRH-a initiated 3-5 days postoperatively was equivalent to that of GnRH-a initiated on days 1-5 of menstruation. Female patients who initiated GnRH-a treatment 3-5 days postoperatively experienced less uterine bleeding during the first cycle of treatment.

Topics: Adult; Drug Administration Schedule; Endometriosis; Estradiol; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Goserelin; Humans; Luteinizing Hormone; Menstruation; Middle Aged; Postoperative Period; Uterine Hemorrhage; Young Adult

To assess the efficacy of tibolone add-back therapy with Goserelin treatment of uterine fibroids.. Randomized placebo-controlled study.. Gynecology department of an inner-city teaching hospital.. Seventy-five women of reproductive age with uterine fibroids.. All women were given monthly SC implants of 3.6 mg goserelin and were randomized to take 3 months of placebo followed by 3 months of tibolone 2.5 mg daily (delayed administration), tibolone 2.5 mg daily for 6 months, or placebo for 6 months.. Changes in bone mineral density (BMD) at the hip and spine, fibroid and uterine size, and patient symptomatology.. In the tibolone group, 2% loss of BMD at the spine was observed compared with 5.5% loss in the placebo group. For total hip, tibolone led to a 0.7% gain in BMD compared with a loss of 1.7% in the placebo group. Tibolone did not affect GnRH analogue-induced fibroid shrinkage. Vasomotor symptom scores in women taking tibolone were 2.2 and were significantly lower than those taking placebo or in the delayed administration groups (mean scores 2.9 and 2.7, respectively).. Tibolone appears to be a safe and effective add-back therapy which can be given from the commencement of GnRH analogue treatment for fibroids.

Topics: Adult; Antineoplastic Agents, Hormonal; Bone and Bones; Bone Density; Chemotherapy, Adjuvant; Cross-Over Studies; Double-Blind Method; Female; Gonadotropin-Releasing Hormone; Goserelin; Humans; Leiomyoma; Middle Aged; Norpregnenes; Patient Compliance; Placebos; Treatment Outcome; Uterine Hemorrhage; Uterine Neoplasms

To evaluate the benefits of systematic preoperative treatment with LH-RH agonists prior to endometrial resection (ER).. The study population was made up of 98 premenopausal women who underwent resectoscopic treatment for abnormal uterine bleeding (AUB) between January 1996 and December 1997. Only patients with endometrial polyps or dysfunctional bleeding were included. The population was divided into two groups: patients who had (group B) and those who had not (group A) received LH-RH before the surgical intervention.. ER was carried out as a single procedure in 66 (67.5%) of the patients. ER plus polypectomy was necessary in 32 (32.5%) patients. There were no differences between the two groups as far as the operating time and total volume of distension medium were concerned. No intraoperative complications were seen in either group. A higher negative balance of distension medium was achieved in group A (320 +/- 23 mL versus 187 +/- 16 mL; P < 0.001), and this difference was not modified when cases with polyps were excluded. The failure rate was similar in both groups both at 12 months [group A 6 (14.8%) versus group B 7 (14.9%) patients] and at 60 months [group A, 11 (21.6%) versus group B 10 (21.2%) patients]. Likewise, the amenorrhea and hypomenorrhea rates at 12 months and at 60 months were also shown to be the same in both groups. When two doses of LH-RH are used and the failure rate is taken into account the cost of an acceptable outcome increases from 843.37 Euro to 1373.49 Euro per patient, while the total cost of a hysterectomy is 1355.42 Euro.. Endometrial suppression with LH-RH agonists did not guarantee better results of ER, but they are strongly recommended during the learning curve to achieve a safer procedure.

Topics: Adult; Endometrial Neoplasms; Endometrium; Female; Gonadotropin-Releasing Hormone; Goserelin; Gynecologic Surgical Procedures; Hormones; Humans; Middle Aged; Polyps; Preoperative Care; Prospective Studies; Treatment Outcome; Uterine Hemorrhage

The aim of this study was to assess the efficacy of topically applied trichloroacetic acid (TCA) for endometrial ablation in patients with dysfunctional uterine bleeding (DUB). This trial has also compared the advantages of prethinning the endometrium with danazol and goserelin acetate before ablation with TCA.. This prospective trial was conducted on 90 volunteer cases. Patients were allocated into three treatment groups comprised of 30 patients. In group I cases underwent dilatation and curettage before endometrial ablation. In group II cases were administered danazol before ablation. Cases in group III received goserelin acetate on the same day and 28 days after ablation. Endometrium was evaluated by biopsy, transvaginal ultrasonography and hysteroscopy. Endometrial ablation was performed with 95% TCA. All of the patients were evaluated 3 and 6 months after TCA application.. After 6 months of treatment, the success rate was recorded as 83% in the first group, 92.3% in the second group and 96.6% in the third group. The mean length of uterine cavity was reduced in all groups, being only significant in Goserelin group (P<0.5). Endometrial thickness was decreased significantly in all treatment groups (P<0.001).. This study concluded that endometrial ablation by TCA may readily be performed as an alternative treatment method in the management of DUB. Moreover, suppression of endometrium with danazol or especially with goserelin acetate before ablation, resulted in significant success rate.

Topics: Administration, Oral; Adult; Caustics; Danazol; Dilatation and Curettage; Endometrium; Estrogen Antagonists; Female; Goserelin; Humans; Injections, Subcutaneous; Middle Aged; Prospective Studies; Treatment Outcome; Trichloroacetic Acid; Uterine Hemorrhage

To report the results of a 3-year follow-up evaluation of a trial comparing goserelin acetate depot injections with sham injections before endometrial ablation for the treatment of dysfunctional uterine bleeding (DUB).. Prospective, randomized, double-blind, parallel-group study.. Thirty-seven centers in 12 countries.. Three-hundred and fifty-eight premenopausal women aged over 30 years with DUB.. Goserelin acetate (3.6 mg depot) every 28 days for 8 weeks, or sham depot every 28 days for 8 weeks, with endometrial ablation 6 weeks +/- 3 days after the first depot injection (i.e., when the endometrium is at its thinnest). The follow-up continued for 3 years.. At the 3-year follow-up, bleeding in the previous 3 months and need for surgical intervention were recorded.. At 3 years, amenorrhea rates were 21% in the goserelin acetate group and 14% in the control group (estimated odds ratio, 1.8; 95% CI, 0.98-3.25; P=.0571). The surgical intervention rate (since the original procedure) was low and did not differ significantly between groups. For hysterectomy, it was 21% for the goserelin acetate group and 15% for the control group. For repeat ablations, it was 5.6% for the goserelin acetate group and 2.1% for the control group.. Prethinning with goserelin acetate before endometrial ablation resulted in higher long-term amenorrhea rates than ablation without prethinning.

Topics: Adult; Amenorrhea; Combined Modality Therapy; Double-Blind Method; Endometrium; Female; Goserelin; Humans; Hysterectomy; Odds Ratio; Prospective Studies; Uterine Hemorrhage

To analyse the cost, effectiveness and cost effectiveness of two endometrial thinning agents prior to laser ablation for dysfunctional uterine bleeding: danazol and goserelin.. A district general hospital.. A retrospective cost effectiveness analysis, from the perspective of the health service, based on data from an open, randomised, parallel group comparative study of 160 pre-menopausal women with dysfunctional uterine bleeding.. Within the trial, length of operation and duration of hospital stay was recorded for each woman. Resource use due to complications of surgery and adverse drug events was evaluated by one of the authors (R.G.). Additional surgery after completion of the study was collected using a postal questionnaire which was distributed to every woman who had undergone surgery. Resource use was costed using detailed unit costs from a specific NHS trust and from published sources. A cost effectiveness analysis was undertaken relating differential cost to differential rates of amenorrhoea at women's last point of follow up.. Information on amenorrhoea was available from 138 women, of whom 111 had completed the questionnaire to indicate longer term follow up. Women who did not complete the clinical trial were not included in this economic evaluation. On average, women randomised to goserelin spent less time in theatre and on the ward. Based on longer term follow up, rates of retreatment were similar in the two groups. The mean (SD) health service cost of women in the goserelin group was pound sterling 323.84 (pound sterling 309.94), compared with pound sterling 243.45 (pound sterling 265.23) in the danazol group; median (range) costs were pound sterling 220.29 (pound sterling 191-pound sterling 2127) and pound sterling 159.76 (pound sterling 140-pound sterling 1426) in the two groups, respectively. These costs were significantly higher for goserelin (P = 0.0001). The goserelin group also had a higher rate of amenorrhoea (38.8% vs 28.6%, P = 0.23). Based on mean differences in cost, the incremental cost of goserelin per additional woman with amenorrhoea was pound sterling 788; based on median differences in cost the ratio was pound sterling 590.. The shorter duration in theatre and stay in hospital provided a modest offset of the higher acquisition cost of goserelin, but the overall cost of management remained significantly higher than managing women with danazol. The rates of amenorrhoea indicated that goserelin was more effective at 24 weeks and approximately two years after surgery, although statistical significance was only achieved at 24 weeks. The economic impact of women withdrawn from treatment was not considered, but sensitivity analysis indicates that these women may have had a large effect on the overall result of this study. Purchasers will need to decide whether the additional cost of management with goserelin is justified by the increased rates of amenorrhoea and the reduced withdrawals from treatment.

Topics: Adult; Antineoplastic Agents, Hormonal; Cost-Benefit Analysis; Danazol; Estrogen Antagonists; Female; Goserelin; Humans; Length of Stay; Randomized Controlled Trials as Topic; Retrospective Studies; Uterine Hemorrhage

To confirm the advantages of goserelin prior to endometrial ablation for the treatment of dysfunctional uterine bleeding.. Multicenter, prospective, randomized, double-blind study.. Cycling premenopausal women with dysfunctional uterine bleeding.. Patients were randomized to goserelin or placebo (sham depot) once monthly for 2 months prior to endometrial ablation. Treatment was timed to allow surgery 6 weeks later on day 7 of the menstrual cycle.. Amenorrhea rates, endometrial histology and thickness, pain and blood loss scores, and surgical parameters.. At 24 weeks after surgery, significantly more goserelin than placebo patients experienced amenorrhea (40% versus 26%). Blood loss was reduced from baseline, but not different between the groups. At surgery, mean endometrial thickness was 1.6 mm and 3.4 mm for the goserelin and placebo groups, respectively, with significantly more atrophic glands and stroma in the goserelin group. Surgery was significantly shorter (by 22%) and easier in the goserelin than in the placebo group, with a significantly lower median fluid absorption in the goserelin groups. In both groups, pain scores were reduced patient satisfaction was high (> 92%), and re-intervention rate was low (2.8%).. Goserelin in combination with endometrial ablation was superior to endometrial ablation alone for the treatment of dysfunctional uterine bleeding.

Topics: Adult; Antineoplastic Agents, Hormonal; Double-Blind Method; Endometrium; Female; Follow-Up Studies; Goserelin; Humans; Hysteroscopy; Prospective Studies; Time Factors; Treatment Outcome; Ultrasonography; Uterine Hemorrhage

To compare the effectiveness of goserelin and danazol prior to endometrial laser ablation and assess different dosage regimens.. A prospective open randomised trial.. Specialist unit in minimal access gynaecological surgery in a district general hospital.. One hundred and sixty premenopausal women with dysfunctional uterine bleeding.. Randomisation into four groups receiving either one or two injections of goserelin acetate (3.6 mg subcutaneously) or 28 or 56 days of danazol (four 200 mg tablets daily), followed by endometrial laser ablation.. Endometrial thickness pretreatment and, immediately prior to endometrial laser ablation, assessed by vaginal ultrasound and full thickness endometrial biopsy; appearance of the endometrium at surgery; duration of the operation; the amount of fluid absorbed during surgery; and the clinical outcome at 24 weeks after surgery.. The two drugs were equally effective in thinning the endometrium. Compared with danazol, goserelin was better tolerated and resulted in a more satisfactory endometrial appearance at hysteroscopy, a greater reduction in cavity length (0.5 cm compared with 0.3 cm, P = 0.002), a shorter operation (16.4 min compared with 21.6 min, P < 0.001), less fluid absorption (0 ml compared with 200 ml, P = 0.001), and a higher rate of amenorrhoea or oligoamenorrhoea (77% compared with 54%, P < 0.001) at the six month check. The administration of goserelin for 8 weeks compared with 4 weeks produced greater thinning of the endometrium on ultrasound and on histological examination, a greater reduction in cavity length on ultrasound and an increase in reported vasomotor symptoms. In both treatment regimens, 95% of women reported a satisfactory reduction in menstrual flow at the six month check.. Goserelin appears to be more effective and better tolerated than danazol for treatment prior to endometrial laser ablation. Eight weeks treatment with goserelin resulted in better operating conditions and more vasomotor side effect, compared with four weeks treatment, although there was no difference in clinical outcome.

Topics: Adult; Danazol; Dose-Response Relationship, Drug; Endometrium; Female; Goserelin; Humans; Laser Therapy; Premenopause; Prospective Studies; Uterine Hemorrhage

To assess the effects of pretreatment with the gonadotropin-releasing hormone analog goserelin on fluid absorption in patients undergoing hysteroscopic endometrial ablation.. Prospective, randomized, placebo-controlled study.. A university-based clinic.. Thirteen women with dysfunctional uterine bleeding who were scheduled for electrosurgical hysteroscopic ablation.. Seven women were randomized to receive luteal phase goserelin 3.75 mg and six saline in the menstrual cycle approximately 10 weeks before surgery. Operative hysteroscopy was carried out with glycine 1.5% mixed with 2% alcohol medium under constant pressure as an irrigant. The amount of irrigant used, irrigant deficit, blood levels of albumin and ethanol, hematocrit, hemoglobin, changes in sodium levels, and central venous pressure were compared between the groups.. All of the patients had an unsuccessful course of medical therapy for at least 3 months and a normal endometrial biopsy. The age, weight, and uterine size were similar between the groups. The mean volume of irrigant used and operating time were similar in both groups (4.18 +/- 0.2 vs 4.5 +/- 0.5 L, and 33.7 +/- 1.5 vs 37 +/- 2.1 min). Although operating time, volume deficit, decrease in protein level, and hematocrit were less in the goserelin than in the saline group, the differences were not statistically significant (p >0.05). The ethanol levels in blood, decrease in Na+, and irrigant deficit were significantly lower in the goserelin than in the saline group (17.4 +/- 3.8 vs 25.3 +/- 4.2 mg/ml, 6.7 +/- 1.2 vs 9.1 +/- 0.9 mEq/L, and 0.49 +/- 0.08 vs 0.66 +/- 0.05 L, respectively; p <0.05).. Based on these results we conclude that in women undergoing hysteroscopic endometrial ablation, pretreatment with goserelin may decrease the absorption of hysteroscopic medium, prevent fluid overload, and improve the outcome possibly by causing hypovascularity and decreased endometrial growth.

Topics: Absorption; Adult; Electrosurgery; Endometrium; Female; Gonadotropin-Releasing Hormone; Goserelin; Humans; Hysteroscopy; Laparoscopy; Middle Aged; Premedication; Prospective Studies; Solutions; Therapeutic Irrigation; Uterine Hemorrhage

This study investigated the efficacy of GnRH agonists concomitantly with transient aromatase inhibitor and tranexamic acid to treat women with uterine arteriovenous malformations (AVMs) associated with abnormal uterine bleeding (AUB) to preserve fertility and determine reproductive outcome.. This was a prospective cohort study in a tertiary centre. Doppler ultrasound demonstrated AVM in 19 women with AUB 1-28 weeks following spontaneous or therapeutic abortion and in one woman 4 years after normal pregnancy while taking an oral contraceptive. On the basis of experience from the first three cases, 17 women were treated with tranexamic acid (1 g three times daily orally for 5 days), a GnRH agonist (3.75-11.25 mg, for 1-3 months), plus an aromatase inhibitor (letrozole 2.5 mg once daily for 5days) with the initial injection of GnRH agonist. Two women required blood transfusion, and one required uterine tamponade with Foley catheter balloon in the first 48 hours to control heavy bleeding (Canadian Task Force Classification II-2).. All 20 AVMs resolved within 1-3 months of treatment. Of 16 women who attempted pregnancy, all (100%), including two who had uterine artery embolization (one after hysteroscopic septoplasty), conceived spontaneously with 18 live births. Two women are using contraception (one taking an oral contraceptive, one using a levonorgestrel intrauterine system), and one 40-year-old is not using contraception. One woman had hysteroscopic endometrial ablation followed by vaginal hysterectomy for AUB at 1 and 2 years later.. A GnRH agonist in combination with transient aromatase inhibitor and tranexamic acid is an effective management strategy to treat and maintain reproduction in women with AVMs associated with AUB.

Topics: Abortion, Spontaneous; Adult; Antifibrinolytic Agents; Aromatase Inhibitors; Arteriovenous Fistula; Arteriovenous Malformations; Blood Transfusion; Cohort Studies; Female; Fertility; Fertility Agents, Female; Gonadotropin-Releasing Hormone; Goserelin; Humans; Letrozole; Leuprolide; Prospective Studies; Tranexamic Acid; Treatment Outcome; Ultrasonography, Doppler; Uterine Artery; Uterine Artery Embolization; Uterine Balloon Tamponade; Uterine Hemorrhage; Uterus

To describe the rates of use and effectiveness of gonadotropin-releasing hormone (GnRH) agonists and other forms of hormonal menstrual suppression in prevention of vaginal bleeding among young women who underwent hematopoietic stem cell transplantation (HCT).. Retrospective descriptive study.. University-based pediatric HCT practice.. Fifty-five postmenarchal women who underwent HCT between 2004 and 2011.. Administration of GnRH agonists or other forms of hormonal menstrual suppression.. Rates of use of GnRH agonists and other forms of hormonal menstrual suppression, and rates and descriptions of vaginal bleeding.. Forty-six of the 55 patients had experienced regular or irregular vaginal bleeding before HCT and were considered to be at risk for thrombocytopenia-associated menorrhagia. Forty of the 46 (87%) received hormonal menstrual suppression. Thirty-three patients were treated with a GnRH agonist, 4 with combined hormonal contraceptive pills, 1 with a combined hormonal contraceptive patch, 1 with depot medroxyprogesterone, and 1 with oral norethindrone. Twenty-nine of the 33 patients (88%) who received a GnRH agonist had complete amenorrhea during HCT and 4 of 33 (12%) experienced some degree of vaginal bleeding.. GnRH agonists appear effective in prevention of vaginal bleeding complications in most postmenarchal women who underwent HCT. Some patients who might benefit do not receive a GnRH agonist and multiple barriers exist in identification and treatment of them.

Topics: Adolescent; Adult; Amenorrhea; Child; Contraceptive Agents, Female; Female; Gonadotropin-Releasing Hormone; Goserelin; Hematopoietic Stem Cell Transplantation; Humans; Leuprolide; Preoperative Care; Retrospective Studies; Treatment Outcome; Uterine Hemorrhage; Young Adult

Hysteroscopic endometrial ablation (HEA) is a new alternative for patients with dysfunctional uterine bleeding (DUB), resistant to medical treatment. The relatively thin endometrium is a big advantage at the time of operation. In this article the results of an initial series of hysteroscopic operations (HEA) are given--as a whole and depending on preoperative treatment with GnRH-agonist. Seventeen patients with DUB underwent HEA. Six of them were pretreated with Goserelin acetate (Zoladex 3.6 mg, Astra Zeneca) two subcutaneous application at 28 days interval. The other 11 women were operated in the early postmenstrual period without medical pretreatment. Comparison was made between the two groups regarding preoperative endometrial thickness, operative time, operative complications, duration of hospital stay, change of the menstrual pattern after 6 and 12 months. Results showed 41.2% achievement of persistent amenorrhoea in patients as a whole (62.7% in the Zoladex group and 27.2% in the untreated group). Better results in the patients with Zoladex pretreatment (shorter operative time, higher incidence of amenorrhoea, patient's higher evaluation of the operation) can be explained with the reduced endometrial thickness at the time procedure. The authors consider the hysteroscopic roller-ball endometrial ablation as an upto-date cost-effective method for treatment of DUB. The method is quick, with very low incidence of complications, easy toleration, immediately recovery of the patient and the only possibility for women with high anaesthesiologic and operative risk. Two depot-doses of Zoladex before hysteroscopy lead to better intra- and postoperative results.

Topics: Adult; Drug Administration Schedule; Endometrium; Female; Follow-Up Studies; Goserelin; Humans; Hysteroscopy; Injections, Subcutaneous; Length of Stay; Middle Aged; Premedication; Treatment Outcome; Uterine Hemorrhage

Gonadotropin releasing hormone agonist (GnRH-agonist) therapy has been useful as an adjunct before myomectomy or hysterectomy for uterine myoma but the concealed risk is often overlooked. We report an extremely rare clinical presentation of a patient with multiple submucosal myomata during the treatment of long-acting gonadotropin-releasing hormone agonist (GnRH-agonist) in a 23-year-old, virgin woman. This patient exhibited heavy menstruation and severe anemia for half of a year. Ultrasound demonstrated multiple submucous myomata and intramural myomata. She received a conservative medical treatment by GnRH-agonist. The patient showed marked suppression of serum estradiol concentrations throughout treatment (< 20 pg/ml since first dose injection). The volume of the uterus decreased 21% and the total volume of the uterine myomata decreased 27% at the end of the second dose injection. However, a sudden onset of major hemorrhage occurred at the 65th day without "add-back" hormonal replacement therapy after initial therapy of GnRH-agonist. Hypovolemic shock followed soon and immediately resuscitation was performed. After resuscitation, the patient was treated with hysteroscopic myomectomy, followed by 30 ml balloon Foley catheter placement for compressing the intrauterine rough surface and hormonal replacement therapy. When uterus returned to the normal size at the end of the first week, intrauterine device was positioned and maintained for three months. The patient married four months later and got pregnant soon. Now she has a pregnancy of 22 gestational weeks. The phenomenon suggests presence of concealed and potential risk of GnRH-agonist for managing a patient with multiple submucous myomata, even though GnRH-agonist is a well-documented transient treatment for uterine myomata not only by its effect on tumor shrinkage and decreasing blood loss during the myomectomy but also by providing a time for hematological recovery. This unexpected and unwanted clinical presentation should be alerted.

Topics: Adult; Female; Goserelin; Humans; Leiomyoma; Uterine Hemorrhage; Uterine Neoplasms

Topics: Antineoplastic Agents, Hormonal; Endometrium; Female; Goserelin; Humans; Menstruation Disturbances; Randomized Controlled Trials as Topic; Uterine Hemorrhage

Topics: Adult; Antineoplastic Agents, Hormonal; Bone Density; Drug Therapy, Combination; Estradiol; Estrogen Replacement Therapy; Female; Follow-Up Studies; Goserelin; Humans; Leiomyoma; Lipid Metabolism; Lipids; Middle Aged; Time Factors; Uterine Hemorrhage; Uterine Neoplasms

Topics: Adult; Female; Goserelin; Humans; Hysterectomy; Leiomyoma; Uterine Hemorrhage

To evaluate the safety and efficacy of Goserelin (Zoladex depot; ICI Pharmaceuticals, Macclesfield, Cheshire, United Kingdom) in the treatment of endometriosis.. Open study.. Eleven centers in Germany and 1 center in Austria.. One hundred forty-six patients with pelvic endometriosis.. Goserelin (Zoladex depot) therapy, one depot (3.6 mg) subcutaneously every 4 weeks for 6 months.. Total subjective score and total pelvic symptom score showed a reduction by 86% and 93%, respectively, at the end of the treatment and did not exceed one fifth of the pretreatment value throughout the follow-up period of 48 weeks. One hundred seven women underwent a second laparoscopy at the end of the therapy for determination of objective efficacy: 54% of the patients showed a reduction of implants and adhesions by at least 50% or more, and 31.5% had a complete resolution of visible deposits. The mean reduction of implants and adhesions was 50%, and the mean reduction of implants 72%. Twenty of 64 (31.3%) previously infertile patients successfully conceived within 12 months after discontinuation of the therapy. Goserelin led to a down regulation of the pituitary ovarian axis and as a pharmacological effect of this hypoestrogenism most patients had hot flushes and vaginal dryness.. Zoladex depot therapy proved to be safe and effective in the medical treatment of endometriosis.

Topics: Adult; Buserelin; Delayed-Action Preparations; Endometriosis; Female; Gonadal Steroid Hormones; Goserelin; Humans; Pregnancy; Uterine Hemorrhage