[Danazol and its effect on bone and lipid metabolism in patients with endometriosis]

Danazol is a synthetic steroid, derived from 17-alpha ethinyltestosterone and it is used primarily in the treatment of endometriosis. It effectiveness is due to a reversible hypoestrogenic and hyperandrogenic state, which lead to atrophy of the ectopic endometrial tissue. A prospective study was undertaken in 14 women of child-bearing age with laparoscopically confirmed pelvic endometriosis to evaluate the alterations produced in bone and lipid metabolism after a six month treatment with Danazol. Laboratory evaluation included: bone mineral density, urine hydroxiproline/creatinine and calcium/creatinine ratios, lipid profile, bone isoenzyme of alkaline phosphatases and plasma estradiol. A significant decrease in plasma estradiol levels was observed (p < 0.001). Decrease in HDL cholesterol and increase in LDL cholesterol levels were statistically significant after 3 and 6 months of medication (p < 0.001), but the lipoproteins returned to normal levels three months after discontinuing Danazol. The bone isoenzyme of alkaline phosphatases showed a progressive increase (p < 0.001) and there were no significant variations in the hydroxyproline/creatinine and calcium/creatinine ratios. The osteodensitometry remained unchanged at 6 months of therapy. We conclude that, even though Danazol produces hypoestrogenism and hyperandrogenism, the markers of bone loss did not change, it has no negative effect on bone mineral density, and the transient worsening of the lipid profile that it causes is reversible on discontinuation of medication.