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
Other OA: closed CC0 RETRACTED ⤵ 38 in-corpus citations
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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

OBJECTIVE: To 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. DESIGN: Retrospective case series. SETTING: Tertiary care, academic medical center. PATIENTS: Eight patients with moderate to severe pelvic pain and laparoscopically documented endometriosis. INTERVENTION: Leuprolide 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. RESULTS: Six 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. CONCLUSION: Treatment 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 Pelvis Progestins Adult Adult Bone Density Bone Density Bone Density Drug Implants Drug Implants Endometriosis Endometriosis Estrogens Estrogens Estrogens Estrogens

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (34)

Cited by (36)

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