warfarin and Endometriosis

Danazol is a synthetic androgenic steroid used clinically for the treatment of a wide variety of disorders. Although there is no extensive evidence that androgens are thrombogenic in humans, there are case reports of cerebral, coronary, and peripheral arterial thrombosis in young male athletes abusing anabolic-androgenic steroids. There are also two reported cases of arterial and venous thrombotic events attributed to danazol therapy. We report two additional cases of limb-threatening arterial thrombosis in patients undergoing danazol therapy, and suggest the possibility that danazol may be an independent risk factor for arterial thrombosis.

Topics: Acute Disease; Adult; Aged; Angiography; Anticoagulants; Arteries; Danazol; Drug Therapy, Combination; Endometriosis; Estrogen Antagonists; Female; Heparin; Humans; Leg; Pain; Platelet Count; Purpura, Thrombocytopenic, Idiopathic; Thrombosis; Urokinase-Type Plasminogen Activator; Warfarin

The advent of hysteroscopic laser surgery has provided an alternative to hysterectomy in women with menorrhagia refractory to other forms of treatment. This procedure has been used with considerable success to reproduce the signs and symptoms of Asherman's syndrome when combined with pretreatment using the synthetic steroid Danocrine (danazol). Experience with 335 patients treated with danazol, 800 mg/d, for 25 days before undergoing hysteroscopy with a neodymium:yttrium-aluminum-garnet laser demonstrated that excellent results (amenorrhea or limited spotting) were achieved in 97% of cases. All 46 patients with clotting disorders did well after surgery. The major complications associated with this procedure were fluid overload, profuse bleeding, postoperative urinary tract infections and postoperative hematometra, all of which were controlled successfully. Only one patient had to discontinue danazol treatment because of an adverse reaction.

Topics: Adolescent; Adult; Danazol; Drug Synergism; Endometriosis; Female; Humans; Hysteroscopy; Laser Therapy; Medroxyprogesterone; Medroxyprogesterone Acetate; Menorrhagia; Middle Aged; Pregnadienes; Premedication; Uterine Hemorrhage; Warfarin

Topics: Adult; Danazol; Drug Interactions; Endometriosis; Female; Heart Valve Diseases; Hematemesis; Humans; Pregnadienes; Prothrombin Time; Warfarin