The medical treatment of mild endometriosis

Cooke ID, Ian Cooke, I D Cooke, E J Thomas, Eric J. Thomas, Thomas EJ
Acta obstetricia et gynecologica Scandinavica · 1989 · vol. 68(S150) , pp. 27–30 · doi:10.1111/aogs.1989.68.s150.27 · PMID:2533449 · W16865646
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Gestrinone effectively improved mild endometriosis in a trial where placebo led to disease progression in 47% of patients, indicating active treatment is preferable to expectant management.

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Abstract

Minor degrees of endometriosis have often been regarded as being of no import and hence remain untreated, but a study of the natural history of endometriosis has demonstrated that 47% (95% confidence limits, 23-71%) of patients (n = 35) given placebo in a double-blind, randomized controlled trial showed progression of the disease when assessed before and after treatment by laparoscopy. The active agent, the progestogen gestrinone, was given at a dose of 2.5 mg twice weekly and resulted in an improvement of the disease (p less than 0.004). Furthermore, follow-up over 12 months showed no significant difference between those patients treated with active agent or placebo, and none between those with persistent disease and those in whom it had been obliterated. These data suggest that a diagnosis of mild endometriosis should be followed by treatment to prevent progressive disease, but that the treatment does not influence subsequent fertility. They indicate that expectant treatment has no place and that even if fertility is not an immediate requirement, active treatment should be instituted, and that the new gestogen, gestrinone is efficacious. Other treatments, such as danazol or luteinizing hormone releasing hormone (LHRH) agonists, or the older contraceptive or pseudopregnancy regimens, must be set against spontaneous improvement (in 5 of 17 patients i.e. 29%) or elimination (in 4 of 17 patients i.e. 24%) in the placebo group. Infertile patients with mild endometriosis have disorders of follicular and luteal function, and in vitro fertilization suggests a reduced fertilization rate.(ABSTRACT TRUNCATED AT 250 WORDS)

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Gestrinone Norpregnatrienes Adult Adult Double-Blind Method Double-Blind Method Endometriosis Endometriosis Endometriosis Female Female Gestrinone Gestrinone Gestrinone Humans Humans Laparoscopy Laparoscopy Norpregnatrienes

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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 ]

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Cited by (26)

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