Reduction in Endometrioma Size with Three Months of Aromatase Inhibition and Progestin Add-Back

Sanjay K Agarwal, Warren G Foster
BioMed research international · 2015 · vol. 2015 , pp. 1–4 · doi:10.1155/2015/878517 · PMID:26247030 · W1547955287
article OA: hybrid CC0 ⤵ 31 in-corpus citations
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A 3-month treatment of aromatase inhibition with progestin add-back significantly reduced mean endometrioma diameter by 50% and volume by 75% in women with endometriosis.

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Abstract

The purpose of this study was to assess the impact of 3 months of aromatase inhibition together with progestin add-back on ovarian endometrioma size. This prospective cohort study was performed at University Medical Center (UC San Diego). Women trying to conceive were excluded. After informed consent, all women were treated with the aromatase inhibitor letrozole (5 mg/d) with norethindrone acetate (5 mg/d) add-back for 3 months. Pre- and posttreatment assessments of endometrioma sizes were performed by ultrasound. The impact of treatment on pain was determined using the patient assessed endpoints of the Biberoglu and Behrman scale. These included assessing dysmenorrhea, dyspareunia, and nonmenstrual pelvic pain each on a scale from 0 to 3. The primary endpoint of this study was the change in ultrasound documented endometrioma size. Fourteen endometriomas in 8 consecutive women were treated for 3 m. Mean endometrioma diameter decreased 50% from 4.6 ± 1.6 cm to 2.3 ± 1.6 cm (mean ± SD). This represents a 75% decrease in endometrioma volume. Endometriosis symptoms of dysmenorrhea, dyspareunia, and nonmenstrual pelvic pain also improved with treatment. In conclusion, a 3-month course of high dose aromatase inhibition with progestin add-back significantly reduces ovarian endometrioma size and warrants further investigation.

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Outcome instruments

Biberoglu-Behrman

Condition tags

mesh:D004715mesh:D017699endometriosisendometriomadysmenorrheadyspareunia

MeSH descriptors

Endometriosis Endometriosis Nitriles Norethindrone Pelvic Pain Triazoles Adult Aromatase Inhibitors Aromatase Inhibitors Cohort Studies Drug Therapy, Combination Drug Therapy, Combination Endometriosis Endometriosis Female Humans Letrozole Longitudinal Studies Nitriles Norethindrone

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References (21)

Cited by (31)

Source provenance

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