Successful treatment of refractory endometriosis-related chronic pelvic pain with aromatase inhibitors in premenopausal patients
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This study investigated the efficacy of aromatase inhibitors in treating refractory endometriosis-related chronic pelvic pain in premenopausal patients, reporting successful outcomes.
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Abstract
OBJECTIVE: Not every patient with endometriosis responds to currently recommended conventional medical treatment regimens. The objective of this study was to determine the efficacy and side effects of aromatase inhibitors in the treatment of premenopausal patients with endometriosis associated with chronic pelvic pain refractory to conventional treatment.
STUDY DESIGN: Four premenopausal patients with documented refractory endometriosis and chronic pelvic pain were treated with aromatase inhibitors, either anastrazole (3) or letrozole (1), for 6 months. The treatment was combined with calcium 1.5 g per day and vitamin D 800 U per day. The main outcome measure was reduction in pelvic pain assessed by visual analogue scale. Side effects were documented and changes in serum LH, FSH and 17-beta estradiol and bone density (Dexa scan) were measured before, during and after treatment.
RESULTS: There was marked improvement in pelvic pain in the four patients. Their mean pain score fell from 9 prior to treatment to 4.5 at the end of treatment. One patient with infertility conceived immediately after completing the treatment. There were no changes in the hormone levels and bone scan scores. The most common side effect was irregular bleeding with anastrazole and joint pains with letrozole.
CONCLUSIONS: Aromatase inhibitors are beneficial in premenopausal women with chronic pelvic pain secondary to refractory endometriosis without compromising fertility and with minimal side effects. Further cohort and comparative studies are needed to confirm these observations.
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- Surgical versus non-surgical intervention in endometriosis with infertility: a patient preference trial 2024
- Letrozole versus dienogest in endometrioma recurrent after surgery: a randomized controlled trial 2022
- Effectiveness of Norethisterone Acetate alone Versus in Combination with Letrozole for treatment of Chronic Pelvic Chronic Pain and Dyspareunia in Patients with Endometriosis 2022
- Potential Therapeutic Options and Perspectives for Alleviation of Endometrial Estrogen Dominance and Progesterone Resistance in Endometriosis 2021
- Evaluation of the effect of aromatase inhibitor in reducing the size of endometrioma 2021
- Uso de inhibidores de la aromatasa en el tratamiento del dolor pélvico asociado a endometriosis: revisión sistemática 2021
- Additional file 1 of Anastrozole and levonorgrestrel-releasing intrauterine device in the treatment of endometriosis: a randomized clinical trial 2021
- Uso de inhibidores de la aromatasa en el tratamiento del dolor pélvico asociado a endometriosis: revisión sistemática 2021
- Superior hypogastric plexus block as an effective treatment method for endometriosis-related chronic pelvic pain: an open-label pilot clinical trial 2020
- Anastrozole and Levonorgrestrel-Releasing Intrauterine Device in the Treatment of Endometriosis: A Randomized Clinical Trial. 2020
- Endometriosis Treatment 2020
- Anastrozole and Levonorgrestrel-Releasing Intrauterine Device in the Treatment of Endometriosis: A Randomized Clinical Trial. 2020
- Anastrozole and Levonorgrestrel-Releasing Intrauterine Device in the Treatment of Endometriosis: A Randomized Clinical Trial. 2020
- Anastrozole and Levonorgrestrel-Releasing Intrauterine Device in the Treatment of Endometriosis: A Randomized Clinical Trial. 2020
- Letrozole combined with oral contraceptives versus oral contraceptives alone in the treatment of endometriosis-related pain symptoms: a pilot study 2020
- Progesterone and Estrogen Signaling in the Endometrium: What Goes Wrong in Endometriosis? 2019
- Letrozole 2019
- Anastrozole and Levonorgrestrel-Releasing Intrauterine Device in the Treatment of Endometriosis: A Randomized Clinical Trial 2019
- New developments in the medical treatment of endometriosis 2017
- Hormonal therapy for endometriosis: from molecular research to bedside 2016
- Experimental treatments of endometriosis 2015
- Effect of Letrozole on endometriosis-related pelvic pain 2014
- Role of Aromatase Inhibitors in the Treatment of Endometriosis 2014
- Aromatase Expression in Endometriosis and Its Significance 2014
- Endometriose 2013
- Efficacy of letrozole in treatment of endometriosis-related pain 2013
- Hormonal strategy for the primary or secondary treatment of endometriosis 2012
- The emerging use of aromatase inhibitors for endometriosis treatment 2011
- The emerging role of epigenetics in the aetiology of endometriosis. 2011
- Are aromatase inhibitors effective in endometriosis treatment? 2011
- Pathophysiological factors and genetic association in endometriosis 2011
- Use of aromatase inhibitors in gynecology 2010
- [Treatment of endometriosis by aromatase inhibitors: efficacy and side effects] 2010
- Effects of Letrozole Compared with Danazol on Patients with Confirmed Endometriosis: A Randomized Clinical Trial 2010
- Letrozole and norethisterone acetate in colorectal endometriosis 2010
- Dienogest, a synthetic progestin, inhibits prostaglandin E2 production and aromatase expression by human endometrial epithelial cells in a spheroid culture system 2010
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