Medical therapy for recurring catamenial pneumothorax following pleurodesis

R L Dotson, Ronald L. Dotson, Dotson RL, C M Peterson, Matthew C. Peterson, Peterson CM, Doucette RC, R C Doucette, Raymond C. Doucette, Quinton R, Ronald Quinton, R Quinton, Rawson DY, Daniel Y. Rawson, D Y Rawson, Jones KP, K P Jones, Kirtly Parker Jones
Obstetrics and gynecology · 1993 · vol. 82(4) , pp. 656–658 · doi:10.1097/00006250-199310000-00038 · PMID:8378002 · W2071593770
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

Leuprolide acetate followed by norethindrone successfully resolved recurring postsurgical catamenial pneumothorax for one year, but recurrence was associated with vaginal bleeding despite hormonal suppression.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-22 · read from full text ⓘ

This case report examines the efficacy of medical therapy for a 44-year-old woman suffering from recurring catamenial pneumothorax after undergoing thoracotomy and abrasive pleurodesis. The patient initially received monthly leuprolide acetate, which was subsequently switched to continuous hormonal suppression using norethindrone. Although this regimen successfully prevented recurrence for one year, the pneumothorax returned when vaginal bleeding resumed during progestin therapy, indicating that successful management requires complete amenorrhea. This paper is centrally about endometriosis — specifically addressing catamenial pneumothorax as a rare complication of systemic endometriosis.

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Abstract

BACKGROUND: Catamenial pneumothorax, a rare complication of systemic endometriosis, has been difficult to treat successfully. Successful medical therapy is associated with amenorrhea. CASE: A 44-year-old white woman with recurring catamenial pneumothorax underwent thoracotomy and abrasive pleurodesis. Following the procedures, pneumothorax occurred again and she was treated with the GnRH analogue leuprolide acetate, 3.75 mg monthly intramuscularly. After 6 months, her therapy was changed to continuous hormonal suppression with norethindrone, 0.7 mg/day. After 6 months of this therapy and into the third episode of vaginal bleeding, the patient had another recurrent pneumothorax. CONCLUSION: Leuprolide acetate followed by continuous hormonal suppression with norethindrone was successful for 1 year in resolving recurring postsurgical catamenial pneumothorax, but the problem recurred with the resumption of vaginal bleeding during progestin therapy. Successful medical therapy requires amenorrhea.
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Background

Catamenial pneumothorax, a rare complication of systemic endometriosis, has been difficult to treat successfully. Successful medical therapy is associated with amenorrhea. Case: A 44-year-old white woman with recurring catamenial pneumothorax underwent thoracotomy and abrasive pleurodesis. Following the procedures, pneumothorax occurred again and she was treated with the GnRH analogue leuprolide acetate, 3.75 mg monthly intramuscularly. After 6 months, her therapy was changed to continuous hormonal suppression with norethindrone, 0.7 mg/day. After 6 months of this therapy and into the third episode of vaginal bleeding, the patient had another recurrent pneumothorax.

Conclusion

Leuprolide acetate followed by continuous hormonal suppression with norethindrone was successful for 1 year in resolving recurring postsurgical catamenial pneumothorax, but the problem recurred with the resumption of vaginal bleeding during progestin therapy. Successful medical therapy requires amenorrhea.(Obstet Gynecol 1993;82:656-8)

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Condition tags

endometriosis

MeSH descriptors

Leuprolide Menstruation Pleura Pneumothorax Adult Female Humans Leuprolide Pleura Pneumothorax Pneumothorax Recurrence

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