Gestrinone versus a gonadotropin-releasing hormone agonist for the treatment of pelvic pain associated with endometriosis: a multicenter, randomized, double-blind study

Fertility and sterility · 1996 · vol. 66(6) , pp. 911–919 · doi:10.1016/s0015-0282(16)58682-8 · PMID:8941054 · W2954123294
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This randomized, double-blind study compared gestrinone and a GnRH agonist for treating pelvic pain associated with endometriosis.

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Abstract

ObjectivesTo evaluate the efficacy of gestrinone versus leuprolide acetate (LA) in improving pelvic pain in women with endometriosis and to compare their effects on bone mineral density and serum lipid profile.DesignMulticenter, double-blind, double-dummy, randomized clinical trial.SettingSix academic departments specialized in the study of endometriosis.Patient(s)Fifty-five women with moderate or severe pelvic pain and laparoscopically diagnosed endometriosis.Intervention(s)Six-month treatment with oral gestrinone (n = 27) or IM depot LA (n = 28) followed by 6-month follow-up.Main outcome measure(s)Variations in severity of dysmenorrhea, deep dyspareunia, and nonmenstrual pain as shown by a visual analog scale and a verbal rating scale, modifications in bone mineral content as shown by dual-roentgenogram absorptiometry, and variations in serum cholesterol subfractions and lipoprotein(a) concentrations.Result(s)Significant improvements were observed in all three symptoms considered in both treatment arms. Moderate or severe pain symptoms recurrence on both pain scales was observed in 2 of 17 (11.8%) patients given gestrinone compared with 9 of 17 (52.9%) of those given LA (odds ratio, 0.12; 95% confidence interval, 0.02 to 0.69). Lumbar bone mineral density increased slightly in the gestrinone group but decreased by 3% in the LA one. High-density-lipoprotein cholesterol fell by 25% and lipoprotein(a) decreased by approximately 40% in the gestrinone-treated women but did not vary in those receiving LA.Conclusion(s)Oral gestrinone is at least as effective as depot LA for pain relief in women with symptomatic endometriosis. A tendency to prolonged pain reduction was observed after gestrinone compared with LA treatment. Gestrinone does not negatively affect bone density but variations in serum lipids need further evaluation.

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Condition tags

dysmenorrheaendometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Gestrinone Leuprolide Pelvic Pain Pelvic Pain Progesterone Congeners Absorptiometry, Photon Adolescent Adult Bone Density Bone Density Double-Blind Method Dysmenorrhea Dysmenorrhea Dysmenorrhea Endometriosis Female Gestrinone Gestrinone Gonadotropin-Releasing Hormone

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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