leuprolide and Metrorrhagia

To study the effectiveness and safety of combined laparoscopy and gonadotropin-releasing hormone agonist (GnRH-a) in the treatment of endometriosis (EM).. From January to December 2010, 198 patients with EM undergoing treatment in Department of Obstetrics and Gynecology, Beijing Anzhen Hospital were randomly divided into three groups, which include 52 cases treated by only laparoscopy in laparoscopy group; 76 cases treated by laparoscopy combined with domestic Leuprolide acetate with dose of 3.75 mg every 28 days in Leuprolide acetate group; 70 cases treated by laparoscopy combined with imported Goserelin acetate with dose of 3.6 mg every 28 days in Goserelin acetate group. The efficacy, pregnancy rate and adverse reactions were compared among the three groups.. Thirteen cases lost following up, including 3 cases in laparoscopy group, 6 cases in Leuprolide acetate group and 4 cases in Goserelin acetate group. (1) Effective rates: effective rates were 47% (23/49) in laparoscopy group, 77% (54/70) in Leuprolide acetate group and 74% (49/66) in Goserelin acetate group. Compared with laparoscopy group, the effective rate of Leuprolide acetate group and Goserelin acetate group was significantly elevated (P < 0.05). There was no statistically significant difference between Leuprolide acetate group and Goserelin acetate group (P > 0.05).(2) Recurrence rate: recurrence rate were 33% (16/49) in laparoscopy group, 13% (9/70) in Leuprolide acetate group and 12% (8/66) in Goserelin acetate group. Compared with laparoscopy group, the recurrence rate of Leuprolide acetate group and Goserelin acetate group was significantly declined (P < 0.05). There was no statistically significant difference between Leuprolide acetate group and Goserelin acetate group (P > 0.05). (3) Pregnancy rate: the number of patients require fertility were 28 cases in laparoscopy group, 39 cases in Leuprolide acetate group and 35 cases in Goserelin acetate group. After 2 years follow up, pregnancy rate of 62% (24/39) in Leuprolide acetate group and 60% (21/35) in Goserelin acetate group were high than 39% (11/28) in laparoscopy group significantly, which did not reached significant difference (P > 0.05). (4) Adverse drug reaction:rates of a adverse reactions were 21% (15/70) in Leuprolide acetate group and 20% (13/66) in Goserelin acetate group, including irregular vaginal bleeding associated with low estrogen level. There was no significant difference in adverse reactions (P > 0.05).. Compared with laparoscopy alone, laparoscopy combined with GnRH-a is more effective in treatment of, which exhibit lower recurrence rate, higher pregnancy rate and fewer adverse reactions. Domestic Leuprolide acetate have similar safety and efficacy compared with imported GnRH-a.

Topics: Adult; Electrocoagulation; Endometriosis; Female; Gonadotropin-Releasing Hormone; Goserelin; Humans; Injections, Subcutaneous; Laparoscopy; Leuprolide; Metrorrhagia; Pregnancy; Pregnancy Rate; Treatment Outcome; Young Adult

In a double-blind, placebo controlled study, ipriflavone (600 mg/day, T.D.D.) or identical placebo tablets were given with 500 mg/day of calcium to patients treated with the gonadotropin hormone-releasing hormone agonist (Gn-RH-A) leuproreline acetate, 3.75 mg every 30 days for 6 months. In placebo-treated subjects (n = 39), urinary hydroxyproline excretion and plasma osteocalcin levels showed a significant (P < 0.01 and P < 0.05, respectively) increase, whereas spine bone density and total body bone density significantly (P < 0.001 and P < 0.05, respectively) decreased after 3 and 6 months of GnRH-A administration. Conversely, in the ipriflavone-treated group (n = 39), no significant difference in bone markers and bone density was evidenced. These data indicate that ipriflavone can restrain the bone remodeling processes and prevent the rapid bone loss that follows medically induced hypogonadism.

Topics: Absorptiometry, Photon; Analysis of Variance; Antineoplastic Agents, Hormonal; Bone Density; Bone Remodeling; Female; Follow-Up Studies; Gonadotropin-Releasing Hormone; Humans; Hypogonadism; Isoflavones; Leiomyoma; Leuprolide; Lumbar Vertebrae; Menopause; Metrorrhagia; Osteoporosis, Postmenopausal; Treatment Outcome; Uterine Neoplasms; Uterus

Endometrial ablation with the Nd:YAG laser can be used to treat recurrent dysfunctional uterine bleeding. Two series of patients were studied. All suffered for at least 1 year with recurrent menometrorrhagia that was unresponsive to other treatments such as hormonal therapy or removal of polyps or fibroids. In the first series, 75 patients presenting with menometrorrhagia were considered for endometrial ablation using Nd:YAG laser, and 23 met conservative requirements. In the second series, 12 of the 25 patients considered met the conservative requirements. The patients in series I received danazol for 30 days before and 30 days after the procedure; patients in series II received leuprolide acetate. All patients were followed for at least 1 year after treatment was discontinued. Of the 35 patients in both series, 21 (60%) were found to have complete cessation of menstruation. Eleven (31.43%) resumed menstruating but at acceptable levels. Three patients (8.57%) had unsatisfactory results, one who later had a repeat ablation and two who had hysterectomies. Thus, 32 of 35 patients were successfully treated without further intervention after laser ablation. Nd:YAG endometrial ablation is efficacious and cost-effective for recurrent menometrorrhagia in selected patients. The additional benefit of this procedure is the avoidance of hysterectomies and postsurgical complications as well as the psychological consequences of a hysterectomy.

Topics: Danazol; Endometrium; Female; Gonadotropin-Releasing Hormone; Hormones; Humans; Laser Therapy; Leuprolide; Metrorrhagia; Postoperative Care; Preoperative Care; Recurrence

We report endometrial adenocarcinoma in two patients shortly after suspending GnRH-agonist treatment for menometrorrhagia and uterine fibromata.

Topics: Adenocarcinoma; Antineoplastic Agents, Hormonal; Female; Humans; Injections, Intramuscular; Leiomyoma; Leuprolide; Metrorrhagia; Middle Aged; Myometrium; Neoplasms, Second Primary; Triptorelin Pamoate; Uterine Neoplasms

In order to assess the efficacy and tolerability of leuprorelin acetate depot in pre-operative flattening of the endometrium prior to hysteroscopic endometrial ablation, 94 patients from eight centres were included in the per protocol analysis.. The patients included were pre- or peri-menopausal, had completed their family planning and had intractable uterine bleeding. The primary target criterion was the reduction in maximum endometrial thickness after two injections of leuprorelin acetate depot with an interval of four weeks between injections. Surgery took place two weeks after the second injection.. Sufficient pre-treatment was achieved in 91.5% of the patients with > 50% decrease and/or a type 1 endometrium according to sonographic and/or endometrial atrophy (Score 11) according to the central histological evaluation. The endometrium was flattened by a mean of 4.0 +/- 4.1 mm. In terms of clinical response, amenorrhoea, hypomenorrhoea or normal menstruation were achieved after endometrial ablation. Hence 91.5% of patients benefited from the overall treatment after six weeks and still 83% after six months. The trial medication was well tolerated overall. The most common side-effect described was hot flushes which could be attributed to the deliberate oestrogen withdrawal.. In view of the good study results, hormone-suppressive pretreatment of the endometrium can be recommended prior to elective ablation. Surgery should take place during the oestrogen-suppressed phase.

Topics: Adult; Biopsy; Delayed-Action Preparations; Drug Administration Schedule; Endometrial Hyperplasia; Endometrium; Female; Humans; Hysteroscopy; Leuprolide; Menorrhagia; Metrorrhagia; Middle Aged; Preoperative Care

The use of long acting gonadotropin-releasing hormone (Gn-RH) agonist produces a reversible hypogonadotropic hypogonadism. This effect has been used as presurgical treatment of uterine myomata, resulting in amenorrhea and reduction in uterus and tumour sizes. We describe the case of a 43 year old patient, having a uterine myoma associated with metrorrhagia, admitted to hospital because of extensive deep phlebothrombosis requiring urgent anticoagulation. Because of the risk of exacerbating metrorrhagia and considering the high morbidity associated to emergency hysterectomy, we decided medical treatment with a depot GnRH agonist (leuprolide acetate 3.75 mg IM monthly). Bleeding ceased within 3 days, allowing the maintenance of anticoagulant treatment. A marked reduction in uterine size postponed total hysterectomy to 3 months later. The characteristics of GnRH analogues, their action mechanisms, adverse effects and other clinical indications are discussed.

Topics: Adult; Female; Humans; Hysterectomy; Leiomyoma; Leuprolide; Metrorrhagia; Remission Induction; Uterine Neoplasms