Clinical significance of add-back therapy in the treatment for endometriosis

Objective To analyze the clinical significances of GnRH-a or low dose estrogen add-back therapy in preventing recurrence in patients with mild or severe endometriosis,who had received conservative surgery.Methods 136 patients with stage III-IV endometriosis after conservative surgery were randomly divided into 2 groups:68 patients in single drug group reveived?GnRH-a(Dophereline) treatment,and 68 patients in add-on drug group received GnRH-a(Dophereline) in combination with low dose of estrogen(Tibolone Tablets).Changes of serum levels of E2,FSH and LH,side effects,serious degree(with improved Kupperman score measured) and the recurrence rate were compared between the two groups.Results Serum levels of E2 in single drug group and add-on drug group were(40.6 ± 18.9) pmol/L and(80.8 ± 21.8) pmol/L after 3 months of treatment(P 0.05).Side effects such as hot flashes diaphoresis was shown in 60 patients(88.2%) in single drug group and 22 patients(32.3%) in add-on drug group(P 0.05).The improved Kupperman total scores in the two groups were(14.2 ± 3.1) points and(6.6 ± 4.2) points(P 0.05),respectively;and the recurrence rates were 10.3%(7/68) and 8.8%(6/68)(P 0.05),respectively.Conclusion Dopherelin and low dose estrogen of Tibolone Tablets as the add-back therapy for mild and severe endometriosis after conservative surgery can effectively increase the serum level of E2 and improve Dophereline side effects,and do not increase the risk of recurrence.