title: Aromatase inhibition for refractory endometriosis-related chronic pelvic pain.
abstract: OBJECTIVE
  To evaluate the use of an aromatase inhibitor for the treatment of endometriosis-related chronic pelvic pain.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Academic medical center outpatient reproductive endocrinology clinic.
  
  
  METHODS
  Sixteen patients with endometriosis and chronic pelvic pain who previously failed conventional medical and/or surgical therapy.
  
  
  METHODS
  Treatment with the aromatase inhibitor letrozole (2.5 mg/d) plus a gonadotropin suppressor (norethindrone acetate, 2.5 mg/d, or a combination oral contraceptive [OC]) for an average of 6 months.
  
  
  METHODS
  Pain scores were reported at each visit using a visual analogue scale from 0 to 10 (0: no pain, 10: maximum pain).
  
  
  RESULTS
  Sixteen patients were treated with an aromatase inhibitor for 180 ± 31 days. The median pain score at the start of therapy was 7, and at the end of therapy it was 1.5. In the nine patients who were evaluated after discontinuing therapy, pain scores returned to pretreatment levels. We did not find any correlation between the length of treatment and the overall improvement in pain score.
  
  
  CONCLUSIONS
  Letrozole plus a gonadotropin suppressor substantially improved pain symptoms in patients with endometriosis refractory to conventional therapies; however, pain recurred after treatment was completed.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA.
authors.forename: Fadi
authors.initials: F
authors.lastname: Abushahin
authors.forename: Kara N
authors.initials: KN
authors.lastname: Goldman
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barbieri
authors.forename: Magdy
authors.initials: M
authors.lastname: Milad
authors.forename: Alfred
authors.initials: A
authors.lastname: Rademaker
authors.forename: Serdar E
authors.initials: SE
authors.lastname: Bulun
mesh_terms: D000293:Adolescent; D000328:Adult; D047072:Aromatase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D002908:Chronic Disease; D004715:Endometriosis / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods; D017699:Pelvic Pain / Q000150:complications* / Q000188:drug therapy*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D047072:Aromatase Inhibitors