Use of danazol in hysteroscopic surgery for menorrhagia

The advent of hysteroscopic laser surgery has provided an alternative to hysterectomy in women with menorrhagia refractory to other forms of treatment. This procedure has been used with considerable success to reproduce the signs and symptoms of Asherman's syndrome when combined with pretreatment using the synthetic steroid Danocrine (danazol). Experience with 335 patients treated with danazol, 800 mg/d, for 25 days before undergoing hysteroscopy with a neodymium:yttrium-aluminum-garnet laser demonstrated that excellent results (amenorrhea or limited spotting) were achieved in 97% of cases. All 46 patients with clotting disorders did well after surgery. The major complications associated with this procedure were fluid overload, profuse bleeding, postoperative urinary tract infections and postoperative hematometra, all of which were controlled successfully. Only one patient had to discontinue danazol treatment because of an adverse reaction.