title: Use of norethindrone acetate alone for postoperative suppression of endometriosis symptoms.
abstract: OBJECTIVE
  To evaluate the efficacy and tolerability of norethindrone acetate (NA) as single-agent hormonal therapy for suppression of endometriosis symptoms in adolescents and young adults.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Two academic medical centers.
  
  
  METHODS
  A keyword search using the query 'NA' was applied to the electronic medical records of all women treated by one gynecologist (M.R.L.) from 1992 to 2010. IRB-approved chart review was then conducted on the index records.
  
  
  METHODS
  Continuous treatment with NA (5-15 mg daily).
  
  
  METHODS
  Postoperative bleeding and pain scores; adverse effects.
  
  
  RESULTS
  One hundred and ninety-four patients with surgically diagnosed endometriosis initiated NA postoperatively during the study period. Median patient age was 18.9 years. 92.2% of patients had stage 1 or 2 disease, and distribution was similar among those excluded. Median pain scores decreased from 5 at NA initiation to 0 at follow-up (P = .0001) and bleeding scores from 2 to 0, respectively (P = .001) for all stages of endometriosis. Post-NA bleeding scores were improved regardless of prior hormonal regimen, and post-NA pain scores improved in all patients except for those previously prescribed GnRH-agonist plus add-back. Most patients (55.2%) did not report any side effects. The most common adverse effect was weight gain (16.1%), with a mean increase in BMI of 1.2 ± 1.6 kg/m(2) at 12 months.
  
  
  CONCLUSIONS
  NA alone is a well-tolerated, effective option to manage pain and bleeding for all stages of endometriosis. Among those on prior hormonal therapy, symptoms improved after NA initiation.
authors.affiliation: Division of Gynecology, Children's Hospital Boston, Boston, Massachusetts, USA; Department of Obstetrics, Gynecology, and Reproductive Biology, Boston, Massachusetts, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Kaser
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Biology, Boston, Massachusetts, USA; Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Missmer
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Biology, Boston, Massachusetts, USA.
authors.forename: K F
authors.initials: KF
authors.lastname: Berry
authors.affiliation: Division of Gynecology, Children's Hospital Boston, Boston, Massachusetts, USA; Department of Obstetrics, Gynecology, and Reproductive Biology, Boston, Massachusetts, USA. Electronic address: Marc.Laufer@childrens.harvard.edu.
authors.forename: M R
authors.initials: MR
authors.lastname: Laufer
mesh_terms: D000293:Adolescent; D000328:Adult; D003280:Contraceptives, Oral, Synthetic / Q000009:adverse effects / Q000627:therapeutic use*; D004715:Endometriosis / Q000150:complications* / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008796:Metrorrhagia / Q000209:etiology*; D009640:Norethindrone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077563:Norethindrone Acetate; D017699:Pelvic Pain / Q000209:etiology*; D012189:Retrospective Studies; D015430:Weight Gain; D055815:Young Adult
chemical_list: D003280:Contraceptives, Oral, Synthetic; D000077563:Norethindrone Acetate; D009640:Norethindrone