Clinical observation on side effects of GnRH-a in treatment of endometriosis

Objective To observe the side effects of GnRH-a for endometriosis after surgery. Methods Thirty-four patients diagnosed as moderate or severe endometriosis,were given goserelin(3.6 mg every 28 days)for total six times from the 3rd day after the operation.Estradiol valerate 0.5-1 mg/d was given as add-back therapy until the end of treatment when E25 pg/ml or hot flashes and sweating symptoms appeared at the second time of medication.The levels of follicle-stimulating hormone(FSH),E2,luteinizing hormone(LH),bone mineral density of the lumbar spine(L-BMD) and bone metabolic biochemical markers(serum calcium and phosphorus)were detected.The levels of sex hormone and bone losses were compared after the add-back therapy.The incidences of side effects and improvement after add-back therapy,the duration of restoration of menstruation and gestation circs were observed. Results Hot flash,sweating symptoms appeared after the first medication,and the other low-estrogenic symptoms were more obvious after the second medication.Hot flash and sweating symptoms were improved after the add-back therapy,while there was no significant relief on vaginal dryness and bone pain.Estrogen level reached the level at menopause after four-week medication.The menstruation restored within 3 months after stopping the GnRH-a treatment.BMD was significantly decreased at 20 week after treatment(P0.05). Conclusion The side effects caused by GnRH-a therapy are significantly individualized.The routine add-back therapy could not release all the symptoms among the patients.The patients should be given the individual treatment.The dosage of GnRH-a could be increased in patients suffering from persistent vaginal bleeding,while reduced in patients with severe side effects.