A double blind randomized study of the treatment of endometriosis with nafarelin or nafarelin plus norethisterone

The objective of this study was compare the efficacy of nafarelin 200 mu g (Group A), nafarelin 400 mu g (Group B) and the combination of nafarelin 200 mu g and norethisterone 1.2 mg (Group C) daily, in treating symptoms of endometriosis, American Fertility Society score and adverse events during 6 months of treatment. A prospective, randomized, double-blind parallel group study was performed in two centers and 49 women with endometriosis diagnosed laparoscopically were included. The patients were seen monthly for physical examination and records were taken for bleeding pattern, symptom score and adverse events. A control laparoscopy was performed at the end of 6 months of treatment. All patients were followed 6 months after treatment. At 3 and 6 months the pelvic examination total score had decreased significantly in all three groups. The total endometriosis score was significantly reduced in Groups B and C. After 2 months the total symptom score showed a significant decrease in Groups B and C. The frequency of hot flushed during the first month of treatment was lowest in Group C, but during the rest of treatment there were no differences between the groups. Best bleeding control was obtained in Group C. We conclude that nafarelin 200 mu g daily has as good an effect on endometriosis symptoms as nafarelin 400 mu g daily, and the addition of norethisterone 1.2 mg results in fewer hot flushes and better bleeding control.