A comparative study of the acceptability and effect of goserelin and nafarelin on endometriosis

The effects of goserelin and nafarelin were compared in a prospective, randomized, open, parallel study of 6 months' treatment of 252 women with symptomatic, laparoscopically proven endometriosis. Twenty-eight departments of obstetrics and gynecology in Sweden, Norway, Denmark and Finland were included. Evaluations were made every 3 months for quantification of pain, bleeding and adverse events and convenience of treatment, and at 3 months after the end of treatment, when a control laparoscopy was performed for evaluation of changes in endometriotic lesion size, color and location. Thirty-nine patients withdrew and 113 women given goserelin and 100 women given nafarelin completed the study. There were no statistically significant differences between the groups, either in adverse events or in bleeding. There were no correlations between location, lesion size or type of lesion, and symptom score in either group, or between treatments with regard to change in endometriosis score. In both groups, the percentage of red and black lesions was reduced while the proportion of white lesions increased. The pain score was significantly reduced in both groups. Local irritation in the nasal mucosa was reported in both groups, mostly in the nafarelin-treated group. The goserelin-treated group also reported local symptoms at the injection site. We conclude that there is no statistically significant difference in treatment results or side-effects between goserelin and nafarelin when used for the treatment of endometriosis.