Pelvic endometriosis is the mysterious disease of theories in terms of its pathophysiology, diagnosis, medical or surgical treatment, and recurrence. Danazol has been the drug of choice in medical treatment of pelvic endometriosis patients since
1970.
Recently many different gonadotrophin releasing hormone agonists (GnRHa) have been introduced since 1983. We analyzed the clinical data which were taken from thirty-three pelvic endometriosis patients with pelvic pain who received Nemestran
(Gestrinone)
2.5mg twice a week for 6 months' duration during the period of December, 1993-January, 1995. We excluded three patients including one patients who gave up to take Nemestran due to severe facial acne and seborrhea and two patients who were lost to
follow-up.
Complete and partial symptomatic relief were attained in 73.3% (N=22) and 26.7% (N=8) of study patients(N=30), respectively.
In the mean time, follow-up laparoscopic examinations(N=18) revealed that complete response, partial response, and failure of treatment were observed in 22.2%(N=4), 66.7% (N=12), and 11.1% (N=2) of patients.
Most common side effect was expectedly facial acne in almost all patients(N=29, 96.7%). Others were break through bleeding(N=20, 66.7%), seborrhea (N=19, 63.3%). weight gain(N=10, 33.3%), facial hot flushing(N=8, 26.7%), throbbing headache(N=3,
10%),
breast atrophy(N=2, 6.7%), mood swing(N=2, 6.7%), LFT abnormalities(N=2, 6.7%), and cramping muscle pain(N=1, 3.3%) in the decreasing frequency.
We concluded that Nemestran is the reasonable and acceptable medical treatment modality in pelvic endometriosis patients with pelvic pain. Nemestran seems to be the first-line drug in pelvic endometriosis patients with the decreased bone density.
|