title: Vaginal danazol for women with rectovaginal endometriosis and pain symptoms persisting after insertion of a levonorgestrel-releasing intrauterine device.
abstract: OBJECTIVE
  To evaluate the effectiveness of treatment with vaginal danazol in improving the pain symptoms caused by rectovaginal endometriosis that persist after insertion of a levonorgestrel-releasing intrauterine device (LNG-IUD).
  
  
  METHODS
  This pilot observational study included 15 women with rectovaginal endometriosis and pain symptoms persisting after LNG-IUD insertion. Vaginal danazol (100mg per day) was self-administered for 6months. The intensity of pain symptoms and the volume of rectovaginal endometriotic nodules were evaluated.
  
  
  RESULTS
  Twelve women were satisfied or very satisfied with the treatment. After treatment with vaginal danazol for 3months, there was a significant decrease in the intensity of pain symptoms compared with their intensity before the administration of danazol. The intensity of pain symptoms decreased further at 6-month follow-up. The volume of the rectovaginal nodules decreased after treatment with vaginal danazol for 6months (1.7±0.8cm(3)) compared with the baseline volume (2.3±0.9cm(3); P<0.001). Adverse effects of the treatment were minimal and well tolerated.
  
  
  CONCLUSIONS
  Although a placebo effect cannot be excluded, the results indicate that vaginal danazol decreases the severity of endometriosis-related pain symptoms after LNG-IUD insertion.
authors.affiliation: Department of Obstetrics and Gynecology, San Martino Hospital and University of Genoa, Genoa, Italy. dr@simoneferrero.com
authors.forename: Simone
authors.initials: S
authors.lastname: Ferrero
authors.forename: Daniela
authors.initials: D
authors.lastname: Tramalloni
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Venturini
authors.forename: Valentino
authors.initials: V
authors.lastname: Remorgida
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000627:therapeutic use; D003613:Danazol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004715:Endometriosis / Q000188:drug therapy* / Q000473:pathology; D004965:Estrogen Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D017060:Patient Satisfaction; D010865:Pilot Projects; D012002:Rectal Diseases / Q000188:drug therapy / Q000473:pathology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014623:Vaginal Diseases / Q000188:drug therapy / Q000473:pathology
chemical_list: D003271:Contraceptive Agents, Female; D004965:Estrogen Antagonists; D016912:Levonorgestrel; D003613:Danazol