nafarelin and Amenorrhea

The aim of this study was to determine whether or not the use of medical pre-treatment of the endometrium improves the outcome of transcervical resection of the endometrium with regards to long-term operative outcome, histological findings and patient satisfaction. A prospective randomized trial comparing three endometrial pre-treatment agents (danazol, medroxyprogesterone acetate or nafarelin) with no pre-treatment was conducted. The main outcome measures were: (i) thickness of the endometrium and myometrium resected; (ii) histological stage of the endometrium at the time of operation; (iii) the presence or absence of menses and (iv) patient satisfaction 1 year post-operatively. Of the three pre-treatments studied, danazol produced a lower median endometrial thickness than the control, showed the greatest ability to induce atrophy of the endometrial glands and stroma (not statistically significant) and produced the highest rate of amenorrhoea (not different to the control). Danazol and nafarelin produced significantly lower median endometrial thickness than no pre-treatment. There were, however, no significant differences in the rates of amenorrhoea in any of the pre-treatment groups compared with that in the control group. No improvement in clinical outcome or patient satisfaction is conferred by the use of medical pre-treatments if transcervical resection of the endometrium is performed in the proliferative phase of the menstrual cycle.

Topics: Amenorrhea; Danazol; Endometrium; Estrogen Antagonists; Female; Hormones; Humans; Medroxyprogesterone Acetate; Menorrhagia; Nafarelin; Patient Satisfaction; Premedication; Prospective Studies; Treatment Outcome; Uterine Hemorrhage

As part of a large, multicenter trial, 82 patients with endometriosis were randomized to 6 months of treatment with either nafarelin or danazol. Among 73 patients who had subjective symptoms (dysmenorrhea, dyspareunia, or pelvic pain) at baseline, 94% of patients treated with nafarelin and 91% of those treated with danazol had improvement. Resolution of physical findings also was observed in similar percentages of patients in each treatment group. Long-term studies are needed to determine whether these two agents are associated with different cure rates or times to recurrence of disease.

Topics: Amenorrhea; Clinical Trials as Topic; Danazol; Endometriosis; Female; Gonadotropin-Releasing Hormone; Humans; Nafarelin; Pain

Nafarelin 400 micrograms daily and danazol 600 mg daily were compared in a double-blind randomized study. Eighty-two patients with endometriosis were treated for 6 months after an initial laparoscopy and 74 had a second laparoscopy. Twenty-two (30%) patients had complete disease regression, 42 (57%) patients had a partial regression, and in 10 (13%) patients disease was unchanged or worse. Both treatments led to significant regression of active disease but not of adhesions. At 3 months follow-up, 34 (64%) patients reported their symptoms were improved, 15 (28%) reported no change, and 4 (8%) were worse. Nafarelin was associated with more hot flushes and headaches, and danazol with more weight gain. No significant differences, however, were noted in treatment efficacy between the two groups.

Topics: Adult; Amenorrhea; Analysis of Variance; Danazol; Double-Blind Method; Endometriosis; Estradiol; Female; Gonadotropin-Releasing Hormone; Humans; Nafarelin; Pregnadienes; Tissue Adhesions; Uterine Neoplasms

A prospective study was carried out a State Institute Hospital "Maĭchin dom" aiming to estimate the efficacy of GnRH-agonist Nafarelin in treating patients with endometriosis. Nafarelin was used by 40 women with endometriosis. The drug was applied as a nasal spray according to a therapeutic scheme and regarding definite criteria. Every patient was followed while using the drug and the following sings were registered: occurrence of amenorrhea, clinical sings, side effects, the period of control lasting for a year after the end of the treatment. In 27 women a quick and long-lasting amenorrhoea was induced with standard doses of the drug, while other 13 needed higher dosage to achieve the same effect. Relief of complaints was registered on 35 women. Improved palpatory status was found in 23 patients. In 4 women the disappearance of endometriomas was confirmed by laparoscopy. The existing side-effects are dos to the appearing hypoestrogenemia. After treatment with Nafarelin, during the period of observation, 5 women got pregnant.

Topics: Administration, Intranasal; Adolescent; Adult; Amenorrhea; Drug Evaluation; Endometriosis; Female; Hormones; Humans; Nafarelin; Prospective Studies; Time Factors