GnRH analogue in assessing chronic pelvic pain in women with residual ovaries

Objective To assess whether suppression of ovarian function by a gonadotrophin releasing hormone (GnRH) analogue could assist in the diagnosis of chronic pelvic pain in women with residual ovaries. Design Uncontrolled, observational study. Setting District general hospital (seven women) and teaching hospital (one woman). Participants; Eight women with residual ovaries and chronic pelvic pain. Interventions Goserelin 3.6 mg every 28 days was used followed by surgery to remove residual ovaries. Main outcome measures The women's response to goserelin and surgery (12 months or more postoperatively) was assessed clinically. Results Goserelin was associated with resolution of pelvic pain in the six women who obtained relief of pain with oophorectomy. The only woman who did not respond to goserelin also failed to gain relief with surgery. One woman who responded to goserelin declined surgery. Conclusions Suppression of ovarian function by GnRH analogues may allow differentiation of pelvic pain caused by the residual ovary syndrome from other causes. This would enable selection of cases likely to benefit from surgery, avoiding potentially difficult surgery in women who will gain little or no relief of symptoms with surgery. Only eight cases are reported and a randomised controlled trial would be required to determine the place of GnRH agonists in the treatment of the residual ovary syndrome.