Reduction of bone mineral density by gonadotropin-releasing hormone agonist, nafarelin, is not completely reversible at 6 months after the cessation of administration.
OBJECTIVE
To determine the reversibility of bone mineral density after the cessation of GnRH agonist treatment for endometriosis.


METHODS
Longitudinal trial with 6-month treatment period and 6-month follow-up.


METHODS
28 Japanese premenopausal women with endometriosis.


METHODS
Daily dose of 400 micrograms nafarelin was administered for 6 months.


RESULTS
The spine bone mineral density was measured by dual energy X-ray absorptiometry, and blood and urinary bone metabolic parameters were analyzed. The decrease of lumbar bone mineral density, which took place during treatment, continued during the first 3 months after the cessation of treatment and did not return to the initial baseline level even at 6 months after the withdrawal of treatment. The biochemical parameters, which showed a state of enhanced bone turnover during nafarelin treatment, almost returned to the pretreatment level 6 months after the termination of treatment.


CONCLUSIONS
These results indicate that relatively long period of bone metabolic change might be required to alter the actual bone mineral density after GnRH analog administration.
Taga
M
M
Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Japan.
Minaguchi
H
H
D000281:Administration, Intranasal; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000652:urine; D003404:Creatinine / Q000652:urine; D004305:Dose-Response Relationship, Drug; D004715:Endometriosis / Q000188:drug therapy*; D004958:Estradiol / Q000097:blood; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006728:Hormones / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008137:Longitudinal Studies; D017274:Nafarelin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015675:Osteocalcin / Q000097:blood; D010024:Osteoporosis / Q000097:blood / Q000139:chemically induced; D017697:Premenopause / Q000378:metabolism; D013997:Time Factors
D006728:Hormones; D015675:Osteocalcin; D017274:Nafarelin; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D003404:Creatinine; D000469:Alkaline Phosphatase; D002118:Calcium