nafarelin and Pelvic-Pain

Endometriosis is treatment when has expressed symptomatic. In spite of increased possibility the current treatment is provisionally. It is applied Danazol, Ru 486, GnRh agonists. Nafarelin diminishes the pain syndrome in 70% of the cases. The relapses are 53.4% for 5 years. However, the GnRH agonists provoke suppress on E2, which lead to transient bones demineralization. Therefore they are impracticable in adolescent age when the bone growth occurs. Therefore in adolescent age for treatment on the endometriosis is recommend low-dose oral contraceptive drugs and in a case of inadequate effect to make Laparoscopic vaporization on the endometriomas by trained operator.

Topics: Adolescent; Contraceptives, Oral, Synthetic; Danazol; Endometriosis; Estrogen Antagonists; Female; Follow-Up Studies; Gonadotropin-Releasing Hormone; Humans; Mifepristone; Nafarelin; Pelvic Pain; Recurrence; Treatment Outcome

To assess whether hormonal treatment of endometriosis improves quality of life for women with endometriosis.. In a prospective, randomized, double-blind, double-dummy study on 48 women with verified endometriosis, the pain pattern and quality of life were registered before, during and after treatment with nafarelin or medroxyprogesterone acetate. The distribution of the studied parameters were tested by means of a Skewness test. ANOVA analysis was used for normally distributed variables and Friedman's analysis and Mann-Whitney U-test for non normally distributed variables.. There was a difference between the 30 women who participated all through the study and the 18 who dropped out. It was noticeable that anxiety-depression and sleep disturbances were significantly more common among the drop outs. There was a significant reduction in symptom score during the study, without any significant difference between the treatment groups. The sleep disturbances and anxiety-depression score improved significantly from before treatment to the end of the follow-up, but the anxiety-depression score increased during the nafarelin treatment period. There was a statistically significant improvement of paid working life in the nafarelin treated group. All the other psycho-social parameters as well as emotional balance improved during the study period without difference between groups.. When hormonal treatment is planned it is very important to take into consideration previous psychosocial experiences of the patient. Factors of importance for quality of life such as sleep disturbances and anxiety-depression improved significantly after treatment with nafarelin or medroxyprogesterone acetate.

Topics: Adolescent; Adult; Anxiety; Depression; Double-Blind Method; Endometriosis; Female; Humans; Medroxyprogesterone Acetate; Middle Aged; Nafarelin; Patient Dropouts; Pelvic Pain; Progesterone Congeners; Prospective Studies; Quality of Life; Sleep Wake Disorders; Statistics, Nonparametric; Surveys and Questionnaires

The aim of the work was estimation of effectiveness of Synarel preparation in the treatment of pelvic pain syndrom caused by endometriosis, and assessment of remission of endometriosal focuses, situated in the small pelvis. Examination were performed on 10 cases which were divided into two groups. First of them the group of 6 patients with the intensive premenstrual pain complaints. The second group involved 4 patients with the little subjective pain ailments, which were treated for sterility. The patients were qualified for the 6-months Synarel treatment in according to the grade of intensification of endometriosis. The studies proved that Synare therapy was well-tolerate and effective in the treatment of intermediate and low-advanced cases of endometriosis with pelvic pain complaints.

Topics: Adult; Endometriosis; Female; Hormones; Humans; Nafarelin; Pelvic Pain; Remission Induction

To determine the effectiveness of a 3-month course of nafarelin and, furthermore, to determine the long-term efficacy in patients treated for 3 and 6 months with nafarelin for symptoms associated with endometriosis.. Double-blind, prospective, multicenter, clinical trial.. Fifteen reproductive endocrine clinics throughout the United States.. One hundred seventy-nine women with pelvic pain and endometriosis.. Patients were assigned randomly to 3 months nafarelin followed by 3 months of placebo (n = 91) or to 6 months nafarelin (n = 88) in a prospective, randomized, double-blind multicenter trial. Patients were followed for 12 months after cessation of therapy.. Patient-reported pain scores and physician-reported physical exam findings.. Pain scores dropped significantly by the end of treatment in both groups. Symptoms recurred in both groups, and pain scores gradually increased during the follow-up period but always remained below baseline in both groups. No significant difference in efficacy was noted between the groups. A total of 26% of patients in each group underwent retreatment for recurrent symptoms.. A 3-month course of nafarelin provided effective symptom relief for endometriosis. One year follow-up demonstrated continued pain relief but with gradual return of symptoms.

Topics: Adult; Double-Blind Method; Endometriosis; Estradiol; Female; Humans; Nafarelin; Pelvic Pain; Placebos; Prospective Studies; Recurrence

Our purpose was to investigate the efficacy of postsurgical treatment with nafarelin in women with advanced endometriosis.. Eligible for trial were women < or = 38 years old with unexplained infertility with or without chronic pelvic pain and stage III or IV endometriosis according to the American Fertility Society, revised, classification who underwent laparotomy as first surgical treatment for debulking or radical surgery of endometriotic lesions. Patients were assigned according to a randomization list to nasal nafarelin, 400 micrograms/day (36 subjects) or placebo nasal spray (39 subjects) for 3 months. Pelvic pain was assessed before first surgery and at the 12-month follow-up visit in women with pelvic pain by means of a multidimensional score system and a 10-point linear pain scale.. No marked differences in pain scores emerged among women allocated to different treatments. The mean reduction of the multidimensional score was 3.6 and 4.0, respectively, in women allocated to nafarelin and placebo and of the 10-point linear scale scores was 7.0 and 6.9. These differences were not statistically significant. Within 1 year from randomization, of the 36 women allocated to nafarelin and the 39 allocated to placebo, seven (19%) and seven (18%), respectively, became pregnant.. This study suggests that medical treatment with nafarelin does not markedly improve pelvic pain and short-term reproductive prognosis in women with stages III and IV endometriosis.

Topics: Administration, Intranasal; Adult; Endometriosis; Female; Humans; Nafarelin; Pelvic Pain; Postoperative Care; Prognosis; Reproduction

To describe a case of acute exacerbation of chronic bilateral maxillary sinusitis during therapy with nafarelin nasal spray for chronic pelvic pain and suspected adenomyosis uteri in a patient of 34 years.. Case report.. In the follicular stage of the cycle a diagnostic laparoscopy was carried out because of unexplained pelvic pain for 2 years with biopsy of the pelvic peritoneum and of the uterine fundus was done, revealing no pathology. One and a half years ago the patient already had a diagnostic laparoscopy for the same reason without pathological findings. Vaginal ultrasound showed minor signs of adenomyosis uteri (irregular structure of the myometrium with small cysts). One week after the operation, a therapy with nafarelin nasal spray was initiated in order to induce a hypoestrogenic state. Fourteen days later the therapy had to be stopped because of acute exacerbation of chronic maxillary sinusitis and Caldwell Luc operation and turbinoplastic was performed.. Resolution of the acute maxillary sinusitis after operative intervention and termination of the above-mentioned medication, resolution of pelvic pain after therapy with leuprolide after 4 weeks.. To our knowledge, this is the first report of an acute exacerbation of a chronic maxillary sinusitis during the administration of nafarelin nasal spray. Gynecologists prescribing nasal sprays should ask their patients about symptoms of chronic sinusitis. Patients with a history of sinusitis should visit an ear, nose and throat (ENT) specialist before initiating therapy with nasal sprays; alternatively, drugs with a different formulation should be used for down-regulation of the ovarian function in order to avoid this complication.

Topics: Administration, Intranasal; Adult; Chronic Disease; Endometriosis; Female; Hormones; Humans; Laparoscopy; Maxillary Sinusitis; Nafarelin; Pelvic Pain

Nafarelin, a gonadotropin-releasing hormone agonist, has been shown to be effective in the treatment of endometriosis. The standard dosage is 200 micrograms bid intranasally. Side effects most commonly include those associated with estrogen deprivation. By assessing estrogen status, the standard dosage can be manipulated to minimize these side effects and increase patient compliance.

Topics: Administration, Intranasal; Adult; Analgesia; Endometriosis; Estradiol; Female; Humans; Nafarelin; Pelvic Pain; Uterine Hemorrhage