title: Effect of insuflated Nafarelin (D-Nal-6-GnRH) upon uterine leiomyomata.
abstract: A nasal spray containing the GnRH analog Nafarelin (D-Nal-6-GnRH) was used to treat 20 patients of reproductive age with clinical and ultrasonographic diagnosis of uterine leiomyomata. Nafarelin showed a high index of efficacy (approximately 65%) in decreasing the volume of myomas. The collateral effects observed were scarce; among these were predominant a decrease of libido and vasomotor symptoms. Although bone pain was not referred, the impact upon osteodensity was not assessed. The effect upon pituitary gonadotropin production as well as that of sexual steroids by GnRH was practically null, and one patient became pregnant. Nonetheless, those symptoms associated with the use of Nafarelin were apparently due to a moderate hypoestrogenism, despite not being substantiated in the laboratory studies. With such disparity, we assume it was given by the route of administration of nasal Nafarelin, which is known to have erratic effects due to limitations in its absorption. Thus, far from being a disadvantage it could be useful in regimes of long term therapy (1-2 years) to avoid the impact of estrogen shortage upon bone turnover. We conclude that Nafarelin through insuflation was highly effective for decreasing the size of uterine leiomyomata.
authors.affiliation: Departamento de Medicina Reproductiva Humana, Hospital Juárez de México, SSA, México, D.F.
authors.forename: A R
authors.initials: AR
authors.lastname: Ayala
authors.forename: E
authors.initials: E
authors.lastname: Meza
authors.forename: R
authors.initials: R
authors.lastname: Cervera Aguilar
authors.forename: I
authors.initials: I
authors.lastname: Hernández Marín
mesh_terms: D000328:Adult; D005260:Female; D006728:Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007327:Insufflation; D007889:Leiomyoma / Q000188:drug therapy*; D017274:Nafarelin / Q000009:adverse effects / Q000627:therapeutic use*; D014594:Uterine Neoplasms / Q000188:drug therapy*
chemical_list: D006728:Hormones; D017274:Nafarelin