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Steroidal drugs in endometriosis
A J Kauppila1, S Telimaa, L Rönnberg
1Department of Obstetrics and Gynecology, University of Oulu, Finland.
Acta Obstetricia Et Gynecologica Scandinavica. Supplement
|January 1, 1989
Summary
Medroxyprogesterone acetate (MPA) and danazol effectively manage endometriosis symptoms and lesions. Their therapeutic benefits likely stem from indirect hormonal actions rather than direct endometrial effects.
Area of Science:
- Reproductive endocrinology
- Gynecology
- Pharmacology
Background:
- Progestins like medroxyprogesterone acetate (MPA), danazol, and gestrinone are used for endometriosis.
- These drugs exhibit progestin-like effects on the intrauterine endometrium.
- Ectopic endometrium shows limited response to hormonal stimuli, suggesting non-endometrial drug actions.
Purpose of the Study:
- To compare the clinical efficacy and side-effects of danazol and high-dose MPA in endometriosis treatment.
- To investigate the impact of these hormonal therapies on infertility and conception rates.
Main Methods:
- A 6-month randomized trial comparing danazol, high-dose MPA, and placebo.
- Assessment of clinical efficacy through symptom relief and lesion disappearance.
- Evaluation of cumulative pregnancy rates at 30 months in infertile patients.
Main Results:
- Danazol and MPA demonstrated equal clinical efficacy in treating endometriosis.
- Danazol therapy resulted in more androgenic and metabolic side-effects compared to MPA.
- No significant difference in cumulative pregnancy rates was observed between danazol, MPA, and placebo groups.
Conclusions:
- The therapeutic effects of steroidal drugs for endometriosis may be primarily due to indirect hormonal actions, such as suppressing ovarian activity.
- While clinically effective, danazol and MPA can cause hormonal and metabolic side effects.
- Hormonal therapy for endometriosis does not significantly improve conception rates in infertile patients and may delay pregnancy.