GnRH Agonists in the Management of Endometriosis: The Results of two Randomized Trials

W. Paul Dmowski, Ewa Radwańska, Zvi Binor, Ian S. Tummon, Peg Pepping
In: GnRH Analogues in Reproduction and Gynecology · 1990 · pp. 7–15 · doi:10.1007/978-94-009-0721-8_2 · W1535043608
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Two randomized trials investigated GnRH agonists for endometriosis management, noting the disease's dependence on ovarian hormones and its resolution after ovarian function cessation.

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This paper reports results from two randomized trials evaluating GnRH agonists for the management of endometriosis, grounded in the concept that ectopic and uterine endometria are hormonally controlled by cyclic ovarian stimulation. At a high level, the trials involve patients treated with GnRH agonists to induce a reversible hypogonadal state, aiming to reduce endometriosis activity by mimicking the ovarian hormone withdrawal seen after menopause. The key reported findings are framed around therapeutic effects consistent with endometriosis atrophy after cessation of ovarian function, while a major caveat highlighted in the broader discussion is the occurrence of reversible hypogonadism–associated adverse effects such as bone loss, which is also referenced in the trials’ context. This paper is centrally about endometriosis — it presents randomized trial results on using GnRH agonists to manage the disease.

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Abstract

Endometriosis is a perplexing disease of unknown etiology and poorly understood histogenesis. It affects women as well as menstruating females of other primate species and is characterized by ectopic i.e., outside of the uterine cavity, growth of endometrium. The growth and spread of endometriosis are controlled by the cyclic stimulation of ovarian hormones. After cessation of ovarian function e.g., during menopause, when ovarian estradiol and progesterone are no longer secreted, uterine as well as ectopic endometria undergo atrophy and endometriosis resolves. Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

Dmowski, WP (1988). Danazol induced pseudomenopause in the management of endometriosis. In R. Rebar (ed.) Clinical Obstetrics and Gynecology, in press Meldrum, DR (1985). Clinical management of endometriosis with luteinizing hormone-releasing hormone analogues. Semin Reprod Endocrinol, 3, 371 The American Fertility Society (1985). Revised American fertility society classification of endometriosis. Fertil Steril, 43, 351 Lee, E (1980). “Statistical Methods for Survival Data Analysis.” (Wadsworth, Belmont) Lemay, A, Maheux, R, Faure, N, Jean, C, and Fazekas, ATA (1984). Reversible hypogonadism induced by a luteinizing hormone-releasing hormone (LH-RH) agonist (Buserelin) as a new therapeutic approach for endometriosis. Fertil Steril, 41, 863 Henig, I, Rawlins, RG, Weinrib, HP and Dmowski, WP (1988). Effects of danazol, gonadotropin releasing hormone agonist and estrogen/progestogen combination on experimental endometriosis in the ovariectomized rat. Fertil Steril, in press Cann, CE, Henzl, M, Burry, K, Andreko, J, Hanson, F, Adamson, D and Trobough, G (1986). Reversible bone loss is induced by GnRH agonists. Program of the Endocrine Society 68th Annual Meeting, June 25–27, Anaheim, CA Lewis, V, Ramos, J, and Dawood, MY (1987). Changes in bone mineral content in endometriosis patients treated with GnRH agonist. Program of the Society for Gynecologic Investigation 34th Annual Meeting, March 18–21, Atlanta, GA Author information Authors and Affiliations Editor information Rights and permissions Copyright information © 1990 Kluwer Academic Publishers About this chapter Cite this chapter Dmowski, W.P., Radwanska, E., Binor, Z., Tummon, I., Pepping, P. (1990). GnRH Agonists in the Management of Endometriosis: The Results of two Randomized Trials. In: Vickery, B.H., Lunenfeld, B. (eds) GnRH Analogues in Reproduction and Gynecology. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-0721-8_2 Download citation DOI: https://doi.org/10.1007/978-94-009-0721-8_2 Publisher Name: Springer, Dordrecht Print ISBN: 978-94-010-6809-3 Online ISBN: 978-94-009-0721-8 eBook Packages: Springer Book Archive

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endometriosis

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