Aromatase inhibitors in recurrent ovarian endometriomas: report of five cases with literature review.
OBJECTIVE
To determine the role of the aromatase inhibitor letrozole in the treatment of recurrent ovarian endometrioma cases.


METHODS
Nonrandomized proof of concept study.


METHODS
Outpatient tertiary-care center.


METHODS
Five premenopausal patients with documented ovarian endometriomas and chronic pelvic pain, all of whom were previously treated with surgery and medicine with unsatisfactory results.


METHODS
Ovarian endometriomas were diagnosed by biopsy after laparoscopic ovarian cystectomy and subsequently treated with hormones. After a 6-month washout of endometriosis hormone therapies, women took letrozole (2.5 mg), one tablet of 0.15 mg of desogestrel, and 0.03 mg of ethinyl estradiol, calcium (1,200 mg), and vitamin D3 (800 IU) daily for 6 months.


METHODS
Size of endometriomas (monitored by ultrasound), assessment of pelvic pain (by visual analog scale), and bone density (DEXA scan).


RESULTS
Disappearance of ovarian endometrioma and reduction in pelvic pain in all cases at the end of 6 months. The size of ovarian endometriomas was reduced after 3 months. Pain scores decreased only after 1 month of treatment and continued decreasing in each treatment month. Overall, no significant change in bone density was detected.


CONCLUSIONS
Letrozole given with combined pills achieved complete regression of recurrent endometriotic cysts and pain relief in all cases.
Lall Seal
Subrata
S
Department of Obstetrics and Gynecology, Bankura Sammilani Medical College, Gobindanagar, West Bengal, India. sealsubrata@gmail.com
Kamilya
Gourisankar
G
Mukherji
Joydev
J
De
Alok
A
Ghosh
Debdatta
D
Majhi
Arup Kr
AK
D000328:Adult; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D004715:Endometriosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077289:Letrozole; D009570:Nitriles / Q000627:therapeutic use*; D012074:Remission Induction; D014230:Triazoles / Q000627:therapeutic use*
D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole