Therapeutic efficacy and bone mineral density response during and following a three-month re-treatment of endometriosis with nafarelin (Synarel).
OBJECTIVE
Our goal was to determine the effects of a repeated course of the gonadotropin-releasing hormone agonist nafarelin on symptoms and signs of endometriosis and lumbar and distal radius bone mineral density.


METHODS
Forty-five women previously treated for 6 months with nafarelin, who had recurrent symptoms and signs of endometriosis, received 400 mcg/day of nafarelin intranasally for 3 months. Efficacy was evaluated by changes in severity of symptoms and signs. Lumbar bone mineral density was measured by dual-energy x-ray absorptiometry and distal radius bone mineral density by single-photon absorptiometry. Bone mineral density was also measured in 10 control volunteers.


RESULTS
Repeated 3-month treatment significantly alleviated recurrent symptoms and signs of endometriosis. Lumbar bone mineral density decreased significantly by a mean of 2% at the end of treatment; this loss was restored within 3 to 6 months after treatment completion. No bone mineral density decline occurred in the radius. Bone mineral density changes in the control group were statistically insignificant.


CONCLUSIONS
A repeated 3-month course of nafarelin treatment significantly relieved recurrent endometriotic symptoms and signs without sustained loss of bone mineral density.
Adamson
G D
GD
Fertility Physicians of Northern California, Palo Alto 94301, USA.
Heinrichs
W L
WL
Henzl
M R
MR
Yuzpe
A A
AA
Bergquist
C
C
Jacobson
J J
JJ
Eriksson
S
S
Kwei
L
L
Gilbert
S M
SM
D000328:Adult; D015519:Bone Density; D004715:Endometriosis / Q000188:drug therapy* / Q000378:metabolism*; D004958:Estradiol / Q000097:blood; D005260:Female; D006728:Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008597:Menstrual Cycle / Q000097:blood; D008875:Middle Aged; D017274:Nafarelin / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D019233:Retreatment; D016896:Treatment Outcome
D006728:Hormones; D017274:Nafarelin; D004958:Estradiol