nafarelin and Dysmenorrhea

To assess the efficacy, safety, and effect on bone mineral density of a 3-month course of retreatment with intranasal nafarelin acetate for recurrent symptoms of endometriosis.. Multicenter, open-label, nonrandomized clinical trial.. Eleven hospital-based and private practices.. Thirty-six women with endometriosis symptoms recurring after 3 or 6 months of treatment with nafarelin.. Nasal nafarelin 200 micrograms twice daily for 3 months.. Assessments for dysmenorrhea, dyspareunia, pelvic pain, tenderness, and induration. Measurement of bone mineral density of the lumbar spine.. Improvements from admission to the end of retreatment were significant for dysmenorrhea, pelvic pain, tenderness, induration, and dyspareunia. Three months after retreatment ended, mean symptom scores for dysmenorrhea and pelvic tenderness, although worse than at the end of retreatment, were still significantly better than scores at admission. Mean bone mineral density 3 months after retreatment was 0.56% lower than before retreatment and 1.94% lower than before initial treatment.. Three-month nafarelin retreatment for recurrent endometriosis symptoms was effective and safe.

Topics: Administration, Intranasal; Adult; Bone Density; Dysmenorrhea; Endometriosis; Female; Hormones; Humans; Middle Aged; Nafarelin; Pain; Recurrence

Topics: Abdominal Pain; Danazol; Diagnosis, Differential; Dysmenorrhea; Endometriosis; Estrogen Antagonists; Female; Gonadotropin-Releasing Hormone; Goserelin; Humans; Hysterectomy; Laparoscopy; Leuprolide; Menorrhagia; Nafarelin; Nursing Assessment; Physical Examination; Progesterone; Severity of Illness Index

Twenty-five women with regular menstruation and laparoscopically confirmed endometriosis received 100 mcg nafarelin intranasally twice daily for six months in an open study. American Fertility Society (AFS) laparoscopic scores pre- and post-treatment, symptom severity, hormonal status, bone density and biochemical indices of bone turnover were studied. Five patients were still menstruating at three months and nafarelin was increased to 400 mcg daily. At the end of treatment, the median serum estradiol was 57 pmol/l and all patients were amenorrhoeic. AFS scores for endometriosis improved significantly in 19/23 (82.6%) patients (p = 0.001). Adhesions were not affected. Symptom severity scores were markedly decreased (p < 0.0001) and remained so six months after the end of treatment. Biochemical indices of bone activation were increased but bone loss was insignificant. During treatment, 23/25 patients reported hot flushes. Nafarelin 200 mcg daily significantly reduced signs and symptoms of endometriosis, although five patients needed a dosage increase before menses stopped. The study suggests that lower doses of nafarelin may be efficacious, although symptomatic changes should be treated with caution due to the open and non-comparative nature of the study.

Topics: Abdominal Pain; Administration, Intranasal; Adult; Bone Density; Dose-Response Relationship, Drug; Dysmenorrhea; Endometriosis; Estradiol; Estrone; Female; Follow-Up Studies; Humans; Infertility, Female; Laparoscopy; Menstruation; Nafarelin; Pregnancy; Severity of Illness Index