COMBINED USE OF A LONG-ACTING GONADOTROPIN-RELEASING-HORMONE AGONIST AND LOW-DOSE DANAZOL IN ADVANCED-STAGE ENDOMETRIOSIS

In this preliminary study, the safety and efficacy of a combined GnRHa and low-dose danazol regimen was evaluated in patients with advanced stage endometriosis. Five patients with. stage IV endometriosis were a dministered triptorelin 3.75 mg intramuscularly with monthly intervals in combination with oral danazol 100 mg/day for 6 months. Laparoscopy was performed before and after therapy to assess the change in endome triotic lesions. During controls, patients were evaluated for the chan ge in hormonal and biochemical parameters and the side effects of the treatment. In 4 patients with ovarian endometriomas, cysts were draine d during initial laparoscopy. None of the endometriomas persisted afte r therapy. Total scores, according to the revised American Fertility S ociety classification of endometriosis were, 54.8+/-10.9 before treatm ent and decreased to 31.6+/-10.3 (P <0.05), whereas, endometriotic imp lants scores changed from an initial value of 22.8+/-12.1 to 1.2+/-1.1 (P <0.05). No adverse effect was observed on lipid and liver metaboli sm. Estrogen deprivation symptoms and oily skin were the most prominen t complaints and one patient had a weight gain of 6 kg. Based on these results we conclude that a combination of GnRHa and low dose danazol is an effective alternative treatment modality in the treatment of sev ere endometriosis without any serious side effect.