Treatment of endometriosis with danazol: report of a 6-year prospective study

Presented are the results of a 6-year prospective study designed to evaluate the effectiveness of danazol for the treatment of endometriosis. Ninety-six patients completed 6 months of therapy at a dosage of 800 mg daily, and 107 patients completed therapy with 400 mg daily. No difference was reported in the incidence of side effects, regardless of dosage. Gross resolution of disease (as determined by second-look laparotomy or laparoscopy) was evaluated in 110 patients and found to be similar, regardless of dosage. Ovarian endometriosis greater than 1 cm was observed to respond significantly less well to danazol than peritoneal or ovarian disease less than 1 cm. Pregnancy rates for 157 patients with no other discernible causes of infertility were slightly higher for the 800-mg danazol regimen than for the 400-mg regimen. In patients with mild disease, the use of danazol alone resulted in pregnancy rates lower than those achieved with conservative surgery alone. Its use preoperatively for all stages of disease resulted in slightly higher pregnancy rates than when conservative surgery alone was employed. Danazol was less effective when used postoperatively. No differences were observed between three classification schemes in their ability to predict subsequent prognosis for conception.