Long-term use of gonadotropin-releasing hormone analogs and hormone replacement therapy in the management of endometriosis: a randomized trial with a 6-year follow-up

S. J. Pierce, Pierce SJ, M.Rafet Gazvani, M R Gazvani, Gazvani MR, Farquharson RG, R. G. Farquharson, Roy G. Farquharson
Fertility and sterility · 2000 · vol. 74(5) , pp. 964–968 · doi:10.1016/s0015-0282(00)01537-5 · PMID:11056241 · W2148647732
RCT OA: closed CC0 ⤵ 49 in-corpus citations
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This randomized trial with a 6-year follow-up assessed the long-term efficacy and safety of gonadotropin-releasing hormone analogs and hormone replacement therapy for endometriosis management.

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Abstract

OBJECTIVE: To identify the effects of long-term GnRH agonist use (6-24 months), with and without add-back therapy, and spontaneous reversibility of bone mass density (BMD) up to 6 years after treatment. DESIGN: A prospective, randomized, long-term follow-up study. SETTING: Obstetrics and gynecology department in a university hospital in the United Kingdom. PATIENT(S): Forty-nine symptomatic women with a laparoscopic diagnosis of endometriosis who had been identified for treatment with long-acting GnRH agonist and volunteered to participate in the study. INTERVENTION(S): Women were randomly allocated to receive hormone replacement therapy (HRT) as a daily oral dose of estradiol, 2 mg, and norethisterone acetate, 1 mg, or no treatment in addition to monthly subcutaneous implants of goserelin acetate for up to 2 years, until cessation of symptoms. Bone mineral density (BMD) at the lumbar spine (C2-C4) and hip (Ward triangle) was measured every 6 months. MAIN OUTCOME MEASURE(S): BMD changes in both groups. RESULT(S): 45 women were followed up for 6 years, at the end of which the groups did not differ significantly in the reduction in mean BMD at the lumbar spine or hip. CONCLUSION(S): BMD reduction occurs during long-term GnRH agonist use and is not fully recovered by up to 6 years after treatment. Use of HRT does not affect this process.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Estradiol Gonadotropin-Releasing Hormone Goserelin Hormone Replacement Therapy Hormone Replacement Therapy Hormone Replacement Therapy Norethindrone Adult Adult Bone Density Bone Density Bone Density Drug Implants Drug Implants Drug Therapy, Combination Drug Therapy, Combination Endometriosis Endometriosis Endometriosis

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (32)

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