Long-term use of gonadotropin-releasing hormone analogs and hormone replacement therapy in the management of endometriosis: a randomized trial with a 6-year follow-up

被引:66
作者
Pierce, SJ [1 ]
Gazvani, MR [1 ]
Farquharson, RG [1 ]
机构
[1] Liverpool Womens Hosp, Dept Obstet & Gynecol, Liverpool, Merseyside, England
关键词
GnRH agonist; endometriosis; long-term; bone density;
D O I
10.1016/S0015-0282(00)01537-5
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To identify the effects of long-term GnRH agonist use (6-24 months), with and without add-back therapy, and spontaneous reversibility of bone mass density (BMD) up to 6 years after treatment. Design: A prospective, randomized, long-term follow-up study. Setting: Obstetrics and gynecology department in a university hospital in the United Kingdom. Patient(s): Forty-nine symptomatic women with a laparoscopic diagnosis of endometriosis who had been identified for treatment with long-acting GnRH agonist and volunteered to participate in the study. Intervention(s): Women were randomly allocated to receive hormone replacement therapy (I-IRT) as a daily oral dose of estradiol, 2 mg, and norethisterone acetate, 1 mg, or no treatment in addition to monthly subcutaneous implants of goserelin acetate for up to 7 years, until cessation of symptoms. Bone mineral density (BMD) at the lumbar spine (C2-C4) and hip (Ward triangle) was measured every 6 months. Main Outcome Measure(s): BMD changes in both groups. Result(s): 45 women were followed up for 6 years, at the end of which the groups did not differ significantly in the reduction in mean BMD at the lumbar spine or hip. Conclusion(s): BMD reduction occurs during long-term GnRH agonist use and is not fully recovered by up to 6 years after treatment. Use of HRT does not affect this process. (Fertil Steril(R) 2000;74:961-8, (C) 2000 by American Society for Reproductive Medicine.)
引用
收藏
页码:964 / 968
页数:5
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