GOSERELIN ACETATE (ZOLADEX)ASTERISK WITH OR WITHOUT HORMONE REPLACEMENT THERAPY FOR THE TREATMENT OF ENDOMETRIOSIS

Objective: To determine whether hormone replacement therapy (HRT) plus goserelin (Zoladex) is as effective as goserelin alone for the relief of pelvic symptoms of endometriosis and to determine whether it reduc es both the loss of bone mineral density (BMD) and the physiologic sid e effects associated with goserelin therapy. Design: Prospective, plac ebo-controlled study, open label for goserelin therapy and double-blin d for HRT. Setting: Forty-two teaching or community hospitals. Patient (s): Premenopausal women with symptomatic endometriosis. Result(s): St atistically significant mean decreases from baseline in the total pelv ic symptom score and total subjective score were observed by week 24 f or all three groups. There were no statistically significant treatment differences for change in total symptom score. Some degree of BMD los s occurred in the three groups; however, the percentage loss was consi stently greater in the HRT0 group than in the HRT1 or HRT2 groups. Whe n analyzed separately, no overall age effect on BMD change was seen in women >30 years of age versus women less than or equal to 30 years. T he HRT1 and HRT2 groups had fewer occurrences of hot hushes and vagina l dryness than did the HRT0 group. Conclusion(s): Goserelin plus HRT i s as effective as goserelin alone in relieving pelvic symptoms of endo metriosis and attenuates both the loss of BMD and the physiologic side effects of hot flushes and vaginal dryness associated with goserelin therapy. (C) 1998 by American Society for Reproductive Medicine.