Endometriosis hormonal treatments

Teichmann AT, Cremer P, Wieland H, Kuhn W, Seidel D. Lipid metabolic changes during hormonal treatment of endometriosis. Maturitas 1988 10(l) 27-33. 

Women with endometriosis receive treatment courses of 6 months duration. Concomitant low-dose hormone replacement therapy has been reported to diminish bone loss without significantly decreasing clinical effectiveness. Women with uterine fibroids that are symptomatic (menorrhagia, anemia, pain) receive treatment courses of 3 months, by which time women have amenorrhea or reduced menorrhagia uterine fibroids are reduced in size an average of 37%. Intramuscular depot preparations containing 3.75 mg (monthly) or 11.5 mg (every 3 months) are used. 

Options are medical hormonal treatments and/or surgery. Surgical treatment by laparoscopic ablation of endometriotic lesions plus adhesiolysis may improve fertility. Hormonal treatments should not be used for endometriosis in women with fertility problems as they tend to lead to ovarian suppression. Laparoscopic ablation of endometrial deposits may relieve pain in some women. Radical surgery (e.g. total abdominal hysterectomy, salpingo-oophorectomy or both) is reserved for women who have completed their family and in whom other treatments have failed. It is usually curative although... 

Danazol is a sex hormone that suppresses the pituitary-ovarian axis by inhibiting output of pituitary gonadotropins has weak, dose-related androgenic activity with no estrogenic or progestational activity. Danazol is indicated in treatment of endometriosis symptomatic treatment of fibrocystic breast disease and in prevention of attacks of hereditary angioedema. 

The progestins are used in the treatment of amenorrhea, endometriosis, and functional uterine bleeding. Progestins are also used as oral contraceptives, either alone or in combination with an estrogen (see the Summary Drug Table Female Hormones and Table 52-1). 

Use synthetic nonapeptidc agonist analog of gonadorelin (LH-RH), gonad stimulating principle for treatment ol hormone sensitive prostatic carcinoma and endometriosis... 

The most common benign gynecological diseases, for prevalence and related economic costs, are probably uterine leiomyomas and endometriosis (Stewart 2001 Missmer et al. 2003). Notwithstanding the fact that both conditions are characterized by a sex-hormone-related development and by the possibility of a medical treatment consisting of hormonal manipulation, at present the main approach to these conditions is surgical excision (Palomba et al. 2006a Olive etal. 2001). 

First we shall describe the effects of tamoxifen, a first-generation SERM used as adjuvant treatment in women with breast cancer, on uterine leiomyomas and endometriosis. Considerable space will be devoted to raloxifene, a second-generation SERM administered for the prevention and treatment of postmenopausal women recently tested for the treatment of these two sex-hormone-related diseases. Unfortunately, at present no or very little data are available on the new third-generation SERMs such as lasofoxifene, idroxifene, droloxifene, ospemifene, azomifene, fulvestrant, and MDL 103.323. 

Medical treatment of endometriosis has focused on the hormonal alteration of the menstrual cycle in an attempt to produce a pseudopregnancy, pseudomenopause, or chronic anovulation (Olive et al. 2001). 

Endometriosis For the treatment of endometriosis amenable to hormonal management. 

Medroxyprogesterone acetate Synthetic progestogen Treatment of menstrual disorders, endometriosis and hormone responsive cancer. Also used as long-acting contraceptive... 

The major uses of progestogens are for hormone replacement therapy and for hormonal contraception where they suppress ovulation and make the cervical mucus impenetrable to spermatozoa. Other indications include secondary amenorrhea, dysmenorrhea, infertility and habitual abortion and endometrium suppression in endometriosis. Progestogens are also used for palliation in metastasized endometrial and breast carcinoma. Medrogestone has been used in the treatment of fibroid uterine tumors. 

Endometriosis -sex hormones for [HORMONES - SEX HORMONES] (Vol 13) -treatment with sex hormones [HORMONES - SEX HORMONES] (Vol 13)... 

Danazol is a weak androgen and also has a series of other hormonal and anti-hormonal properties. It inhibits pituitary gonadotropin and has been used in the treatment of endometriosis, fibrocystic disease of the breast, idiopathic thrombocytopenic purpura, and hereditary angioedema. Its hepatotoxic effects include reversible rises in serum transaminases and cholestatic hepatitis a few cases of hepatocellular tumors have been reported. 

Moghissi KS, Schlaff WD, Olive DL, Skinner MA, Yin H. Goserelin acetate (Zoladex) with or without hormone replacement therapy for the treatment of endometriosis. Fertil Steril 1998 69(6) 1056-62. 

This luteinizing hormone-releasing hormone has been used in the treatment of endometriosis and hormone-dependent tumors. Modes of administration have included injections, nasal sprays and subcutaneous implantations. One study, conducted in pigs, demonstrated the value of glycodeoxycholate (a penetration enhancer) in improving the bioavailability of buserelin by up to five-fold after buccal delivery. ... 

Tahara M, Matsuoka T, Yokoi T, Tasaka K, Kurachi H, Murata Y. Treatment of endometriosis with a decreasing dosage of a gonadotropin-releasing hormone agonist (nafarelin) a pilot study with low-dose agonist therapy ( draw-back therapy). Fertil SterU 2000 73(4) 799-804. 

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