LH-RH agonist (Buserelin): treatment of endometriosis

Summary To investigate the effects of the LH-RH agonist Buserelin [D-Ser (But)6 des — Gly10 — LHRH ethylamide] on endometriosis, 64 patients were treated with 900 μg/d Buserelin intranasally over 6 months after histological verification of the disease. As shown by the follow-up operation at the end of treatment, 73% of cases showed regression of implants, whereas adhesions seemed to be unaffected. The uncorrected pregnancy rate of the 45 patients with a history of infertility was 40%, while the overall recurrence rate —confirmed by histological examination — was 9.4%. The endocrine parameters demonstrated a highly significant suppression of estradiol (E2) and a sharp decline of progesterone (Prog), indicating anovulatory cycles. Folliclestimulating hormone (FSH) was unchanged, while luteinizing hormone (LH) and prolactin (Prl) decreased significantly. The androgenic parameters testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), and sex-hormone-binding globulin (SHBG) revealed no relevant changes. Influence on bone metabolism could not be detected by measuring calcitonin and parathyroid hormone fragments (PTH-C and PTH-MM). Negative metabolic effects were absent in terms of hematology, clotting system, liver enzymes, renal parameters and lipid metabolism. Remarkable was a significant increase of high-density-lipoprotein cholesterol (HDL). Subjective complaints were mostly attributed to the therapy — induced hypoestrogenism. We consider Buserelin to be an effective drug in the treatment of endometriosis, with a low incidence of relevannt side effects. Similar content being viewed by others References Abbasi R, Hodgen GD (1986) Predicting the predisposition to osteoporosis. JAMA 255:1600–1604 American Fertility Society (1979) Classification of endometriosis. Fertil Steril 32:633 Andrews WC, Larsen GD (1974) Endometriosis treatment with hormonal pseudopregnancy and/or operation. Am J Obstet Gynecol 118:643–651 Chalmers JA, Shervington PC (1984) The management of endometriosis. Singapore J Obstet Gynaecol 15:31–37 Cirkel U, Schweppe KW (1985) Side effects of medical treatment of endometriosis. A comparison of Danazol and LH-RH analogue (Buserelin). Arch Gynecol 237:307 Cirkel U, Schweppe KW, Hanker JP, Schneider HPG (1986a) Endocrine effects of GnRH-analogue in endometriosis patients. In: Genazzani AR, Volpe A, Facchinetti F (eds) Proceedings of the First International Congress on Gynecological Endocrinology, Parthenon, London, pp 629–632 Cirkel U, Schweppe KW, Ochs H, Schneider HPG (1986b) Effect of LH-RH agonist therapy in the treatment of endometriosis (German experience). In: Rolland R, Chadha DR, Willemsen WNP (eds) Gonadotropin down-regulation in gynecological practice. Liss, New York, pp 189–199 Comite F, Jensen P (1988) Bone density changes associated with GnRH analogues. International Symposium on GnRH Analogues in Cancer and Human Reproduction, Geneva. (Gynecological endocrinology, vol 2) Parthenon, London, p 105 Daniels GC, Booth JD, Loriaux DL, Cutler GB (1986) Treatment of polycystic ovarian disease (PCO) with a GnRH agonist. Paper presented at the 42nd Annual Meeting of the American Fertility Society and 18th Annual Meeting of the Canadian Fertility and Andrology Society. AFS and Canadian Fertility and Andrology Society, p. 114 Davis MR (1987) Screening for postmenopausal osteoporosis. Am J Obstet Gynecol 156:1–5 DiZerega GS, Hodgen GD (1981) Luteal phase dysfunction infertility: a sequel to aberrant folliculogenesis. Fertil Steril 35:489 Dmowski WP, Cohen MR (1978) Antigonadotropin (Danazol) in the treatment of endometriosis. Am J Obstet Gynecol 130:41–48 Fåhraeus L, Sydsjö A, Wallentin L (1986) Lipoprotein changes during treatment of pelvic endometriosis with medroxyprogesterone acetate. Fertil Steril 45:503–506 Hanker JP, Bohnet HG, Mühlenstedt D, Nowack C, Schneider HPG (1978) Gonadotropin release during chronic administration of D-Ser (TBU)6 — LHRH-EA in functional amenorrhea. Acta Endocrinol (Copenh) 89:625–631 Hardt W, Genz T, Schmidt-Gollwitzer M (1985) The treatment of endometriosis with LH-RH agonists. In: Schmidt-Gollwitzer M (ed) LH-RH and its analogues, fertility and antifertility aspects. de Gruyter, Berlin, pp 349–354 Henriques ES (1979) Long-term follow-up of endometriosis treated with danazol. Paper presented at the American College of Obstetricians and Gynecologists Annual Clinical Meeting, New York Holt JP, Keller D (1984) Danazol treatment incrases serum enzyme levels. Fertil Steril 41:70–74 Jänne O, Kauppila A, Kokko E, Lantto T, Rönnberg L, Vihko R (1981) Estrogen and progestin receptors in endometriosis lesions: comparison with endometrial tissue Am J Obstet Gynecol 141:562–566 Lemay A, Maheux R, Faure N, Jean C, Fazekas ATA (1984) Reversible hypogonadism induced by a luteinizing hormone releasing hormone (LH-RH) agonist (Buserelin) as a new therapeutic approach for endometriosis. Fertil Steril 41:863–871 Lemay A, Maheux R, Quesnel G, Bureau M, Faure N, Mérat P (1987) LH-RH agonist treatment of endometriosis. In: Bruhat MA, Canis M (eds) Endometriosis. Karger, Basel, pp 247–253 Meldrum DR (1975) Management of endometriosis with gonadotropin-releasing hormone agonists. Fertil Steril 44:581–582 Meldrum DR, Chang RJ, Lu J, Vale W, Rivier J, Judd HL (1982) “Medical oophorectomy” using a long-acting GnRH agonist — a possible new approach to the treatment of endometriosis. J Clin Endocrinol Metab 54:1081–1083 Ochs H, Cirkel U, Schweppe KW, Schneider HPG (1988) Abhängigkeit zwischen ovarieller Suppression und Rückgang der Endometriose-Implantate bei LHRH-Analog (Buserelin)-Therapie 47. Kongress der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe, Munich. Ber Gynakol 125:615 Puleo JG, Hammond CB (1983) Conservative treatment of endometriosis externa: the effects of Danazol therapy. Fertil Steril 40:164–169 Sandow J, Fraser HM, Geisthövel F (1986) Pharmacology and experimental basis of therapy with LHRH agonists in women. In: Rolland R, Chadha DR, Willemsen WNP (eds) Gonadotropin down-regulation in gynecological practice. Liss, New York, pp 1–27 Schriock E, Monroe SE, Henzl M, Jaffe RB (1985) Treatment of endometriosis with a potent agonist of gonadotropin-releasing hormone (nafarelin). Fertil Steril 44:583–588 Schweppe KW (1984) Morphologie und Klinik der Endometriose. Schattauer, Stuttgart, p 95 Schweppe KW, Assmann G (1984) Changes of plasma lipids and lipoprotein levels during Danazol treatment for endometriosis. Horm Metab Res 16:593–597 Schweppe KW, Wynn RM, Beller FK (1984) Ultrastructural comparision of endometriotic implants and eutopic endometrium. Am J Obstet Gynecol 148:1024–1039 Shaw RW, Fraser HM, Boyle H (1983) Intranasal treatment with luteinizing hormone releasing hormone agonist in women with endometriosis. Br Med J 287:1667–1669 Teichmann AT, Wieland H, Cremer R, Kuhn W, Seidel D (1984) Lipoproteinveränderungen unter Lynestrenol und Danazol in der hormonellen Behandlung der Endometrose. Geburtshife Frauenheilkd 44:171–175 Tummon I, Pepping P, Rawlins R, Ali A, Dmowski WP (1987) Effect of ovarian suppression with GnRH agonist (GnRH-a) or Danazol on bone mineral density (BMD) in endometriosis. Paper presented at the 43rd Annual Meeting of the American Fertility Society, Reno, Nev. AFS, p 2 Waibel S, Bremen T, Schiffl R, Scharla S, Wüster C, Ziegler R, Minne HW, Leyendecker G (1988) Bone density in patients treated with GnRH agonists for myomata and endometriosis. International Symposium on GnRH Analogues in Cancer and Human Reproduction, Geneva. (Gynecological endocrinology, vol 2) Parthenon, London, p 106 Author information Authors and Affiliations Rights and permissions About this article Cite this article Cirkel, U., Schweppe, K.W., Ochs, H. et al. LH-RH agonist (Buserelin): treatment of endometriosis. Arch Gynecol Obstet 246, 139–151 (1989). https://doi.org/10.1007/BF00934075 Received: Accepted: Issue date: DOI: https://doi.org/10.1007/BF00934075