Evaluation of efficacy and safety of depot medroxyprogesterone acetate in treatment of patients with recurrent pain of postoperative endometriosis

AIM: To evaluate the efficacy and safety of depot medroxyprogesterone acetate in the treatment of patients with recurrent pain of postoperative endometriosis. METHODS: 48 women suffering from recurrent pain of postoperative endometriosis were randomized into either of the following two groups: 25 cases in the group of DMPA received intramuscular depot medroxyprogesterone acetate 150 mg every 28-30 days for 24 weeks; 23 cases in the other group of danazol took danazol 400- 600 mg everyday for 24 weeks. Symptoms and signs were recorded before and after the treatment, and the menstrual and weight changes were also recorded. The levels of the liver and renal function, and sex hormone were examined at the same time. RESULTS: Total subjective symptoms scores of DMPA showed the decrement of 82.5% after 12-week and 92.5% after 24-week treatment. The size decreased 41.5% in ovarian endometriooma after 12-week treatment and 56.2% after 24-week treatment, respectively (P 0.05), The total snbjective symptoms scores were decreased 84.1% and 95.1% respectively after 12-week and 24-week treatment in the group of receiving danazol. Reductions of 34.4% and 52.2% in ovarian endometriooma were observed after 12 weeks and 24 weeks treatment, respectively (P 0.05). Serum E 2 remained on the levels of early follicular phase in two groups. The main side effects of DMPA were irregular bleeding or spotting, delaying of ovulation and weight gaining. A long-term use of DMPA typically results in amenorrhea. Liver functional lesion and anabolic/androgenic side effects of weight gainning and acne were more common in the group of receiving danazol. CONCLUSION: Depot medroxyprogesterone acetate is an effective agent in treatment of patients with recurrent pain of postoperative endometriosis because of its convenience, low-cost and good compliance with little side effects. It can be used repeatedly over a long period of time.