NOVEL VAGINAL DANAZOL RING THERAPY FOR PELVIC ENDOMETRIOSIS, IN PARTICULAR DEEPLY INFILTRATING ENDOMETRIOSIS

Danazol is routinely administered orally to inhibit ovulation and to t reat pel,ic endometriosis, However, recent evidence suggests that dana zol can act directly on endometriotic tissue in vitro to inhibit DNA s ynthesis and induce apoptosis, Danazol was administered via the vagina in this study, using a vaginal ring drug delivery system containing 1 500 mg of danazol, This therapy was effective for treatment of pelvic endometriosis, especially for deeply infiltrating endometriosis, resul ting in a cure of dysmenorrhoea and tenderness in the cul-de-sac withi n 3 months, and of induration or nodularity in the cul-de-sac within 7 months. Moreover, conception was possible during insertion of the vag inal ring in 17 out of 31 infertile women with deeply infiltrating end ometriosis, and in two out of eight infertile women with ovarian endom etriotic cysts not adhering to the cul-de-sac and without deeply infil trating endometriosis. Serum danazol concentrations, high during oral daily 400 mg danazol therapy, but undetectable during vaginal danazol ring therapy, explain why ovulation and conception could occur during insertion of the vaginal danazol ring, and why general side-effects, w hich are often observed during oral danazol therapy, were not observed during vaginal danazol ring therapy. Danazol seems to be absorbed thr ough the vaginal mucosa and reaches the deeply infiltrating endometrio sis via diffusion.