[Two case reports of long-term treatment of endometriosis with cyproterone acetate]

P Schorer, Schorer P, A. E. Schindler, Schindler AE
Zentralblatt für Gynäkologie · 2001 · doi:10.1055/s-2001-12516 · PMID:11340959
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Two case reports demonstrate that long-term cyproterone acetate treatment is beneficial for severe endometriosis, particularly when combined with signs of hyperandrogenism.

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This paper presents two case reports describing the signs and symptoms and a long-term therapeutic strategy for severe endometriosis, using cyproterone acetate as part of conservative hormonal management. The authors frame conservative options as dominated by GnRH analogs, gestagens, and danazol, and report that when hyperandrogenism signs are present, prolonged cyproterone acetate is described as beneficial for maintaining long-term treatment. The explicit limitation is that the evidence is based on only two patients and is not presented as a comparative or controlled study. This paper is centrally about endometriosis — it reports long-term treatment sequences with cyproterone acetate in two cases of severe endometriosis.

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Abstract

Endometriosis is a benign, chronic disease with high incidence during the female fertile period. Conservative treatment is dominated by the use of GnRH-analog substances, Gestagens and Danazol. As a case report we present the signs and symptoms, as well as the long term therapeutical strategy in two cases of severe endometriosis. Combined with signs of hyperandrogenism, the long term use of cyproteroneacetate is beneficial.
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Subscribe to RSS DOI: 10.1055/s-2001-12516 J.A.Barth Verlag in Medizinverlage Heidelberg GmbH & Co.KG Falldarstellung von zwei Endometrioselangzeitbehandlungen mit Cyproteronacetat Long term treatment of endometriosis with cyproteroneacetatePublication History Publication Date: 31 December 2001 (online) Zusammenfassung Die Endometriose ist eine gutartige, chronische Erkrankung mit hoher prämenopausaler Inzidenz. Die konservative Therapie wird von GnRH-Analoga, Gestagenen und Danazol dominiert. Vorgestellt wird der Leidensweg und die Therapiesequenz als Langzeitbehandlung bei zwei Patientinnen mit schwerer Endometriose. Bei zusätzlichen Androgenisierungserscheinungen bietet sich als erfolgreiche Langzeiterhaltungstherapie die Gabe von Cyproteronacetat an. Long term treatment of endometriosis with cyproteroneacetate Summary Endometriosis is a benign, chronical disease with high incidence during the female fertile period. Conservative treatment is dominated by the use of GnRH-analog substances, Gestagens and Danazol. As a case report we present the signs and symptoms, as well as the long term therapeutical strategy in two cases of severe endometriosis. Combined with signs of hyperandrogenism, the long term use of cyproteronacetate is beneficial. MeSH C13.371.163 endometriosis Schlüsselwörter Endometriose - Cyproteronacetat - Langzeitbehandlung - rezidivierende Endometriose Key words Endometriosis - cyproteroneacetate - long term treatment - recurrent endometriosis Literatur - 1 Barbieri R L, Ryan K J. Danazol: Endocrine phamacology and therapeutic application. Am J Obstet Gynecol. 1981; 141 453-463 - 2 Christensen B, Freie H M, Schindler A E. Endometriose - Diagnose und Therapie. Ergebnisse einer aktuellen Umfrage unter 6 700 westdeutschen Gynäkologen. Geburtsh Frauenheilk. 1995; 55 674-679 - 3 Eisermann J, Gast M G. et al . Tumor necrosis factor in peritoneal fluid of women undergoing laparoscopic surgery. Fertil Steril. 1988; 50 573-579 - 4 Fedele L, Arcaini L, Bianchi S, Baglioni A, Vercellini F. Comparison of Cyproterone acetate and danazol in the treatment of pelvic pain associated with endometriosis. Obstet Gynecol. 1989; 73 1000-1004 - 5 Haney F, Weinberg J B. Reduction of intraperitoneal inflammation associated with endometriosis by treatment with MPA. Am J Obstet Gynecol. 1988; 159 450 - 6 Halme J, Becker S, Haskill S. Altered maturation and function of peritoneal macrophages: possible role in the pathogenesis of endometriosis. Am J Obstet Gynecol. 1987; 156 783-789 - 7 Kauppila A. Changing conceps of medical treatment of endometriosis. Acta Obstet Gynecol Scand. 1993; 72 324-336 - 8 Kauppila A. Reappraisal of Progesins in endometriosis therapy. Eur J Endocrinol. 1998; 138 134-136 - 9 Kauppila A, Rönnberg L. Steroidrezeptoren im endometrischen Gewebe. Endometriose. 1986; 4 56 - 10 Katsuki Y, Takano Y, Futamura Y. et al . Effects of dienogest, a synthetic steroid, on experimental endometriosis in rats. Eur J Endocrinol. 1998; 138 216-226 - 11 Schweppe K W. The importance of progestins in the treatment of endometriosis. Zentralbl Gynakol. 1997; 119 (Suppl. 2) 64-69 - 12 Schweppe K W. Morphologie und Klinik der Endometriose. Schattauer, Stuttgart, New York 1984 - 13 Taketani Y, Kuo T M, Mizuno M. Comparison of cytokine levels and embryo toxicity in peritoneal fluid in infertile women with untreated or treated endometriosis. Am J Obstet Gynecol. 1992; 167 265-270 - 14 Vercellini P, Cortesi I, Crosignani P G. Progestins for symptomatic endometriosis: A critical analysis of the evidence. Fertil Steril. 1997; 68 393-401 - 15 Wheeler J M, Malinak L R. Recurrent endometriosis: incidencemanagement, and prognosis. Am J Obstet Gynecol. 1983; 146 247-253 Dr. med. P. M.W. Schorer Prof. Dr. med. A. E. Schindler Abteilung für Gynäkologie insbesondere gynäkologische Onkologie Zentrum für Frauenheilkunde Universitätsklinikum Essen Hufelandstr. 55 D-45122 Essen

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Condition tags

endometriosis

MeSH descriptors

Androgen Antagonists Cyproterone Acetate Endometriosis Laparoscopy Adult Androgen Antagonists Combined Modality Therapy Cyproterone Acetate Endometriosis Endometriosis Female Humans Recurrence Reoperation Severity of Illness Index

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