EFFECTS OF A GONADOTROPIN-RELEASING-HORMONE AGONIST ON THE CALCIUM-PARATHYROID AXIS AND BONE TURNOVER IN WOMEN WITH ENDOMETRIOSIS

OBJECTIVE: Our purpose was to investigate the effects of nafarelin on bone turnover and mass (bone mineral density, in grams per square cent imeter) in women with endometriosis. STUDY DESIGN: We monitored 22 you ng women with endometriosis during and 6 months after 6 months of nafa relin treatment. We compared the bone mineral density status of these women with that of healthy controls undergoing sequential bone mineral density measurement. RESULTS: Subjects had a 2.2% loss in L2-4 bone m ineral density by 6 months, increasing 3 months later to 3% and return ing toward baseline by 6 months after treatment. Radius bone mineral d ensity did not change in the treatment group. Bone mineral density did not change in controls. Serum and urinary calcium levels rose during treatment. Hydroxyproline excretion increased and remained elevated 6 months after treatment. A rise in serum osteocalcin persisted 3 months after therapy but normalized by 6 months. CONCLUSIONS: Bone mineral d ensity deficits with nafarelin are reversible. Increased bone turnover persists 6 months beyond treatment, demonstrating the need for carefu l monitoring of women receiving prolonged or repeated treatment.