Endometriosis 1990

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Endometriosis affects women of reproductive age with pelvic pain, infertility, or masses, and current hormonal treatments like danazol and GnRH agonists have varying side effect profiles.

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Summary Endometriosis is an extremely common gynaecological disease, affecting between 1 and 5% of women of reproductive age. Women with endometriosis typically present for medical care with one of more of the following problems: pelvic pain, infertility, or a large adnexal mass (an endometrioma). The primary treatment for an endometrioma is surgical. However, long term postoperative hormone therapy may be necessary to prevent new endometriomas from developing. There is no evidence that hormonal therapy of endometriosis will improve fecundability in women with endometriosis and infertility. Pelvic pain due to endometriosis can be successfully treated with hormonal agents in the majority of patients. Four basic hormonal regimens are currently available for the treatment of endometriosis: (a) danazol; (b) gonadotrophin-releasing hormone (GnRH) [luteinising hormone-releasing hormone (LHRH); gonadorelin] agonists; (c) progestérones (progestins); and (d) combined estrogens and progesterones. Randomised, controlled, clinical trials suggest that danazol and the GnRH agonists are equally effective in the treatment of endometriosis. However, the side effects caused by danazol and the GnRH agonists are markedly different. Danazol produces androgenic side effects including weight gain, hirsutism, acne, oily skin and deepening of the voice. GnRH agonists produce side effects due to hypoestrogenism, including hot flushes, osteoporosis and dry vagina. The ideal drug regimen for the treatment of endometriosis remains to be developed. Similar content being viewed by others References Barbieri RL. Endometriosis. Current Problems in Obstetrics, Gynecology and Fertility 12: 6–31, 1989 Barbieri RL, Canick JA, Makris A, Davies IJ, Ryan KJ. Danazol inhibits steroidogenesis. Fertility and Sterility 28: 809–813, 1977 Barbieri RL, Evans S, Kistner RW. Danazol in the treatment of endometriosis: analysis of 100 cases with a 4 year follow up. Fertility and Sterility 37: 737–746, 1982 Barbieri FL, Lee H, Ryan KJ. Danazol binding to rat androgen, glucocorticoid, progesterone and estrogen receptors: correlation with biologic activity. Fertility and Sterility 31: 182–186, 1979 Barbieri RL, Niloff JM, Bast RC, Schaetzl E, Kistner RW, et al. Elevated serum concentrations of CA-125 in patients with advanced endometriosis. Fertility and Sterility 45: 630–634, 1986 Barbieri RL, Ryan KJ. Danazol endocrine pharmacology and therapeutic applications. American Journal of Obstetrics and Gynecology 141: 456–463, 1981 Bast RC, Klug TL, St John E, Jenison E, Niloff JM, et al. A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer. New England Journal of Medicine 309: 883–888, 1983 Chrisp P, Goa KL. Nafarelin: a review of its pharmacodynamic and pharmacokinetic properties, and clinical potential in sex hormone-related conditions. Drugs 39: 523–551, 1990 Cramer DW. Epidemiology of endometriosis. In Wilson EA (Ed.) Endometriosis, pp. 5–22, AR Liss, New York, 1987 Crowsley WF, Filicori M, Sprah DI, Santoro NF. The physiology of gonadotropin releasing hormone secretion in men and women. Recent Progress in Hormone Research 41: 473–531, 1985 Filicori M, Flamigni C. GnRH agonists and antagonists: current clinical status. Drugs 35: 63–82, 1988 Henzl MR, Corson SL, Moghissi K, Buttram VC, Berquist C, et al. Administration of nasal nafarelin as compared with oral danazol for endometriosis: a multicenter double-blind comparative trial. New England Journal of Medicine 318: 485–489, 1988 Holt JP, Keller D. Danazol treatment increases serum enzymes. Fertility and Sterility 41: 70–74, 1984 Janne O, Kauppila A, Kokko E. Estrogen and progestin receptors in endometriotic lesions: comparison with endometrial tissue. American Journal of Obstetrics and Gynecology 141: 562–566, 1981 Kistner RW. The use of newer progestins in the treatment of endometriosis. American Journal of Obstetrics and Gynecology 75: 264–278, 1958 Kistner RW. The treatment of endometriosis by inducing pseudopregnancy with ovarian hormones: a report of 58 cases. Fertility and Sterility 10: 539–545, 1959 Lindsay R, Hart DM, Forrest C. Prevention of spinal osteoporosis in oophorectomised women. Lancet 2: 1151–1154, 1980 Luciano AA, Turksoy RN, Careo J. Evaluation of oral medroxyprogesterone acetate in the treatment of endometriosis. Obstetrics and Gynecology 72: 323–327, 1988 Noble AD, Letchworth AT. Medical treatment for endometriosis: a comparative trial. Postgraduate Medical Journal (Suppl. 15) 55: 37–43, 1979 Pittaway DE, Fayez JA. The use of CA-125 in the diagnosis and management of endometriosis. Fertility and Sterility 46: 790–795, 1986 Ranney B. Endometriosis III. Complete operations, reasons, sequelae, treatment. American Journal of Obstetrics and Gynecology 109: 1137–1144, 1971 Seibel MM, Berger MJ, Weinstein FJK, Taymor ML. The effectiveness of danazol on subsequent fertility in minimal endometriosis. Fertility and Sterility 38: 534–537, 1982 Strathy JH, Molgaard CA, Coulam CB, Melton LJ. Endometriosis and infertility: a laparoscopic study of endometriosis among fertile and infertile women. Fertility and Sterility 38: 667–672, 1982 Tamaya T, Motoyama T, Ohono Y. Steroid receptor levels and histology of endometriosis and adenomyosis. Fertility and Sterility 31: 396–400, 1979 Author information Authors and Affiliations Rights and permissions About this article Cite this article Barbieri, R.L. Endometriosis 1990. Drugs 39, 502–510 (1990). https://doi.org/10.2165/00003495-199039040-00003 Published: Issue date: DOI: https://doi.org/10.2165/00003495-199039040-00003

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mesh:D004715endometriosis

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Endometriosis Endometriosis Female Humans

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