Gonadotropin-releasing hormone agonist plus estrogen-progestin “add-back” therapy for endometriosis-related pelvic pain

A J Friedman, Andrew J. Friedman, Friedman AJ, Hornstein MD, Mark D. Hornstein, M D Hornstein
Fertility and Sterility · 1993 · vol. 60(2) , pp. 236–241 · doi:10.1016/s0015-0282(16)56090-7 · PMID:8339817 · W80342516
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This study investigated the efficacy of gonadotropin-releasing hormone agonist combined with estrogen-progestin add-back therapy in managing endometriosis-related pelvic pain.

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Abstract

ObjectiveTo evaluate the safety and efficacy of leuprolide acetate depot (LA, Lupron; TAP Pharmaceuticals, Deerfield, IL) plus daily conjugated equine estrogens (Es, Premarin; Wyeth-Ayerst Laboratories, Philadelphia, PA), and medroxyprogesterone acetate (MPA, Provera; The Upjohn Company, Kalamazoo, MI) "add-back" treatment of endometriosis-associated pelvic pain.DesignRetrospective case series.SettingTertiary care, academic medical center.PatientsEight patients with moderate to severe pelvic pain and laparoscopically documented endometriosis.InterventionLeuprolide acetate depot 3.75 mg IM every 4 weeks for 24 months. Oral conjugated equine Es 0.625 mg/d plus MPA 2.5 mg/d were also taken from treatment months 3 through 24.ResultsSix women completed the 2-year study. Mean revised endometriosis scores for implants, adhesions, and total values were significantly reduced at the conclusion of treatment from pretreatment scores. Self-reported pelvic pain scores were significantly lower at treatment months 3, 6, 12, 18, 24, and 6 months after therapy than pretreatment scores. Dual X-ray absorptiometry bone density measurements of the lumbar spine did not change significantly during the 24-month treatment period. The proportion of women experiencing hot flushes was significantly reduced after E-progestin add-back treatment from the proportion at treatment month 3.ConclusionTreatment with LA depot plus conjugated equine Es and MPA for 2 years was a safe and effective therapy for women with endometriosis and pelvic pain in this small retrospective study.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Estrogens Leuprolide Pain Pelvis Progestins Adult Bone Density Bone Density Drug Implants Endometriosis Estrogens Estrogens Estrogens Female Humans Leuprolide Leuprolide Leuprolide Menstruation

Citation neighborhood

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Cited by (38)

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