THERAPEUTIC EFFICACY AND BONE-MINERAL DENSITY RESPONSE DURING AND FOLLOWING A 3-MONTH RETREATMENT OF ENDOMETRIOSIS WITH NAFARELIN (SYNAREL)

OBJECTIVE: Our goal was to determine the effects of a repeated course of the gonadotropin-releasing hormone agonist nafarelin on symptoms an d signs of endometriosis and lumbar and distal radius bone mineral den sity. STUDY DESIGN: Forty-five women previously treated for 6 months w ith nafarelin, who had recurrent symptoms and signs of endometriosis, received 400 mcg/day of nafarelin intranasally for 3 months. Efficacy was evaluated by changes in severity of symptoms and signs. Lumbar bon e mineral density was measured by dual-energy x-ray absorptiometry and distal radius bone mineral density by single-photon absorptiometry. B one mineral density was also measured in 10 control volunteers. RESULT S: Repeated 3-month treatment significantly alleviated recurrent sympt oms and signs of endometriosis. Lumbar bone mineral density decreased significantly by a mean of 2% at the end of treatment; this loss was r estored within 3 to 6 months after treatment completion. No bone miner al density decline occurred in the radius. Bone mineral density change s in the control group were statistically insignificant. CONCLUSIONS: A repeated 3-month course of nafarelin treatment significantly relieve d recurrent endometriotic symptoms and signs without sustained loss of bone mineral density.