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Uryan I, Taskin O, Erden F, et al. Effectiveness and Long-Term Safety of Prolonged Gosereline and Tibolone in Women with Endometriosis. J Am Assoc Gynecol Laparosc. 1996;3(4):S51-2doi: 10.1016/s1074-3804(96)80309-4.
Uryan, I., Taskin, O., Erden, F., Buhur, A., Burak, F., Ozekici, U., & Wheeler, J. M. (1996). Effectiveness and Long-Term Safety of Prolonged Gosereline and Tibolone in Women with Endometriosis. The Journal of the American Association of Gynecologic Laparoscopists, 3(4), S51-2. https://doi.org/10.1016/s1074-3804(96)80309-4
Uryan, et al. "Effectiveness and Long-Term Safety of Prolonged Gosereline and Tibolone in Women with Endometriosis." The Journal of the American Association of Gynecologic Laparoscopists vol. 3,4 (1996): S51-2. doi: https://doi.org/10.1016/s1074-3804(96)80309-4
Uryan I, Taskin O, Erden F, Buhur A, Burak F, Ozekici U, Wheeler JM. Effectiveness and Long-Term Safety of Prolonged Gosereline and Tibolone in Women with Endometriosis. J Am Assoc Gynecol Laparosc. 1996 Aug;3(4):S51-2. doi: 10.1016/s1074-3804(96)80309-4. PMID: 9074253.
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J Am Assoc Gynecol Laparosc. 1996 Aug;3(4):S51-2. doi: 10.1016/s1074-3804(96)80309-4.

Effectiveness and Long-Term Safety of Prolonged Gosereline and Tibolone in Women with Endometriosis.

The Journal of the American Association of Gynecologic Laparoscopists

Uryan, Taskin, Erden, Buhur, Burak, Ozekici, Wheeler

Affiliations

  1. Inonu University Medical School, Malatya, Turkey.

PMID: 9074253 DOI: 10.1016/s1074-3804(96)80309-4

Abstract

Gonadotropin-releasing hormone (GnRH) agonists are widely administered to treat endometriosis, but generally are not prescribed for more than 6 months since they are associated with vasomotor symptoms and bone loss. A GnRH agonist and steroid add-back therapy can be given for longer times without flare-up or significant hypoestrogenic symptoms. We examined the efficacy and safety of a weak estrogenic steroid, OD14, with prolonged goserelin treatment in seven regularly menstruating women (age 26-33 yrs) with laparoscopically diagnosed, symptomatic endometriosis. The women received goserelin 3.65 mg subcutaneously/month and 2.5 mg OD14 2.5 mg/day beginning in the fourth cycle for 18 to 20 months. The frequency and severity of hot flushes, sweating, irritability, loss of libido, nervousness, and sleeplessness were scored by the women on a scale of 0 to 6 and compared. Samples of blood and urine were obtained to measure serum estradiol (E2) levels, lipids, and urinary calcium:creatinine (Ca:Cr) ratios at the start of treatment and monthly thereafter. The vasomotor scores, serum E2 levels, and urine Ca:Cr ratios were consistent with the hypoestrogenism induced by goserelin (24.2 ± 3.1, 18.5 ± 7.2 pg/ml, and 0.063 ± 0.008, respectively). The decreases in vasomotor scoring with regard to hot flushing, sweating, and urinary Ca:Cr ratios were significant after adding OD14 (14.8 ± 2.2, 0.031 ± 0.005, p <0.05), whereas E2 levels remained below 40 pg/ml (23.1 ± 8.2 pg/ml, p >0.05) throughout therapy. The increased low-density:high-density lipoprotein ratio with goserelin improved with OD14, remaining at the lower limit of normal. Thus, OD14 add-back to GnRH agonist therapy enabled us to extend medical therapy of endometriosis longer than 6 months, preventing hypoestrogenic side effects, and with adequate suppression endometriosis symptoms.

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