Complete remission of OC-resistant catamenial shoulder joint pain and inguinal pain associated with extraperitoneal endometriosis following personalized GnRH agonist therapy.
BACKGROUND
Patients with severe extraperitoneal endometriosis require rapid remission and cannot wait for the effects of oral contraceptive hormones (OCs) to appear.


METHODS
We successfully achieved personalized gonadotropin-releasing hormone agonist (GnRHa) therapy for a patient with catamenial right shoulder joint pain and right inguinal pain associated with extraperitoneal endometriosis, which was completely unable to be suppressed by OCs. A total of 15 subcutaneous GnRHa depot injections over a period of 19 months was performed according to the serum estradiol and LH levels, in order to maintain long-term amenorrhea without any estrogen-deprivation effects. No recurrence of the catamenial symptoms has been observed for more than 35 months after the final GnRHa depot injection.


CONCLUSIONS
Personalized GnRHa therapy should become the first-choice therapy for OC-resistant inoperable extraperitoneal endometriosis.
Tanaka
T
T
Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan. tetanaka@wakayama-med.ac.jp
Umesaki
N
N
D004715:Endometriosis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007264:Inguinal Canal / Q000473:pathology; D007279:Injections, Subcutaneous; D016729:Leuprolide / Q000008:administration & dosage*; D008875:Middle Aged; D020069:Shoulder Pain / Q000188:drug therapy / Q000209:etiology
D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide