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 Cancer and Human Reproduction · 1990 · pp. 7–15 · doi:10.1007/978-94-009-2169-6_2 · W4246959703
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This study investigated GnRH agonists for endometriosis management, noting that the disease is hormone-dependent and resolves with ovarian function cessation.

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This paper reports results from two randomized trials assessing GnRH agonists used in the management of endometriosis, motivated by the idea that endometriosis growth depends on cyclic ovarian hormone stimulation and that ovarian hormone cessation leads to atrophy and resolution of both uterine and ectopic endometrial tissue. The studies were conducted in women with endometriosis and compared outcomes under GnRH agonist treatment, with the core finding that inducing a reversible hypogonadal state can control the disease activity. A major limitation explicitly acknowledged in the surrounding literature is that GnRH agonists can produce hypoestrogenic effects, including reversible bone loss, as highlighted by referenced reports. This paper is centrally about endometriosis — it focuses on randomized trial results for GnRH agonists as treatment for endometriosis.

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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 Editors and Affiliations Rights and permissions Copyright information © 1990 Springer Science+Business Media Dordrecht 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 Cancer and Human Reproduction. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-2169-6_2 Download citation DOI: https://doi.org/10.1007/978-94-009-2169-6_2 Publisher Name: Springer, Dordrecht Print ISBN: 978-94-010-7474-2 Online ISBN: 978-94-009-2169-6 eBook Packages: Springer Book Archive

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endometriosis

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