Bone mass in endometriosis patients treated with GnRH agonist implant or danazol.
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Abstract
Before treatment, the trabecular bone mineral content of the lumbar spine and femoral neck was not significantly different between endometriosis patients and age-matched controls (N = 26). In 17 subjects treated with a monthly goserelin implant, serum estradiol (E2) levels were suppressed into the menopausal range. Mean decreases from pre-treatment values in the lumbar spine and femoral neck were -5.7 and -3.8% at 3 months and -8.2 and -7.7% at 6 months of treatment, respectively; lumbar spine values were significantly different (P less than .05) from those of the control group, whose values changed little during the same period. Significant increases over baseline values were also observed in urinary calcium-creatinine ratio and serum alkaline phosphatase. In nine danazol-treated subjects, serum E2 levels were generally within the early follicular-phase range. There were no significant changes in bone assessments. Normal menses returned within 2 months after cessation of either medication. Six months after goserelin treatment, the lumbar spine and femoral neck bone mineral content was still reduced but to values not significantly different from the pre-treatment and control values; urinary calcium-creatinine ratio was decreased, whereas serum alkaline phosphatase was still elevated. The rapid and deep suppression of ovarian steroidogenesis by a monthly goserelin implant induced significant bone loss compared with the control and danazol groups. This loss was not reversed completely 6 months after cessation of treatment, but bone densities at that time were not different from those of controls. Studies of larger numbers of patients followed for longer periods will be required to resolve the question of complete reversibility.
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- Thrombospondin-1 Mimetic Peptide ABT-898 Affects Neovascularization and Survival of Human Endometriotic Lesions in a Mouse Model 2012
- Gynaecological uses of a new class of steroids: the selective progesterone receptor modulators 2009
- Ovulation suppression for endometriosis for women with subfertility 2007
- Endometriosis 2007
- Long-term fracture risk among women with proven endometriosis 2006
- Long-term effects on bone mineral density and bone metabolism of 6 months’ treatment with gonadotropin-releasing hormone analogues in Japanese women: comparison of buserelin acetate with leuprolide acetate 2005
- Selective progesterone receptor modulators and progesterone antagonists: mechanisms of action and clinical applications 2005
- Gonadotrophin-releasing hormone analogues for endometriosis: bone mineral density 2003
- Ovulation suppression for endometriosis 2003
- HRT as add-back therapy 2002
- Estroprogestin vs. gonadotrophin agonists plus estroprogestin in the treatment of endometriosis-related pelvic pain: a randomized trial 2000
- Gonadotrophin-releasing hormone analogues for pain associated with endometriosis 1999
- Low-dose danazol after combined surgical and medical therapy reduces the incidence of pelvic pain in women with moderate and severe endometriosis 1999
- Gonadotrophin-releasing hormone analogues for pain associated with endometriosis 1999
- GnRH agonists and add‐back therapy: is there a perfect combination? 1998
- The evidence for the management of endometriosis 1998
- Clinical Usefulness of Urinary CrossLaps as a Sensitive Marker of Bone Metabolism. 1997
- Characterization and bioavailability of danazol-hydroxypropyl β-cyclodextrin coprecipitates 1996
- Reduction of bone mineral density by gonadotropin‐releasing hormone agonist, nafarelin, is not completely reversible at 6 months after the cessation of administration 1996
- Urinary N-Telopeptides to Monitor Bone Resorption While on GnRH Agonist Therapy 1996
- Spontaneous reversibility of bone loss induced by gonadotropin-releasing hormone analog treatment. 1996
- Medroxyprogesterone acetate supplementation diminishes the hypoestrogenic side effects of gonadotropin-releasing hormone agonist without changing its efficacy in endometriosis 1996
- Excretion of urinary n-telopeptides reflects changes in bone turnover during ovarian suppression and indicates individually variable estradiol threshold for bone loss 1996
- Goserelin 1996
- Spontaneous reversibility of bone loss induced by gonadotropin-releasing hormone analog treatment 1996
- Evidence that the loss of bone mass induced by GnRH agonists is not totally recovered 1995
- Goserelin (Zoladex) and the skeleton 1994
- Leuprorelin 1994
- Gonadotropin-releasing hormone agonist plus estrogen-progestin “add-back” therapy for endometriosis-related pelvic pain 1993
- An alternative to hysterectomy? GnRH analogue combined with hormone replacement therapy 1993
- MANAGEMENT OF ENDOMETRIOSIS IN WOMEN OLDER THAN 40 YEARS OF AGE 1993
- 9 Endometriosis: Medical therapy 1993
- Severe endometriosis treated with gonadotrophin releasing hormone agonist and continuous combined hormone replacement therapy 1992
- Goserelin (Zoladex ) depot in the treatment of endometriosis 1992
- Endometriosis 1992
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