title: Initiation of GnRH agonist treatment on 3-5 days postoperatively in endometriosis patients: a randomized controlled trial.
abstract: Seventy patients with stage III or IV endometriosis were randomly assigned to 2 groups after conservative surgery. Group O (n = 35) received 3 cycles of a 28-day gonadotropin-releasing hormone agonist (GnRH-a) treatment (goserelin, 3.6 mg) starting 3-5 days postoperatively. Group M (n = 35) received the same treatment starting on days 1-5 of menstruation. Groups were further subdivided according to add-back treatment. Pre- and posttreated levels of estradiol (E2 ), follicle stimulating hormone (FSH), and luteinizing hormone (LH) and visual analog scale (VAS), Kupperman menopausal index (KMI), and bone mineral density (BMD) scores were recorded. The incidence of uterine bleeding was assessed. In both groups, serum levels of E2 , FSH, and LH and VAS scores decreased significantly after treatment. Spotting was the most frequent bleeding pattern. During cycle 1, the bleeding time in group M was much longer that than that in group O (P =.001), and the bleeding rate in group M was significantly higher than that in group O (P =.024, RR = 1.185). In patients with stage III or IV endometriosis, the efficacy of GnRH-a initiated 3-5 days postoperatively was equivalent to that of GnRH-a initiated on days 1-5 of menstruation. Female patients who initiated GnRH-a treatment 3-5 days postoperatively experienced less uterine bleeding during the first cycle of treatment.
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Gong
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Shaofen
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynecology, BenQ Medical Center, Nanjing, Jiangsu, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Qiqi
authors.initials: Q
authors.lastname: Long
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Shien
authors.initials: S
authors.lastname: Zou
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Yuankui
authors.initials: Y
authors.lastname: Cao
mesh_terms: D000328:Adult; D004334:Drug Administration Schedule; D004715:Endometriosis / Q000097:blood / Q000188:drug therapy*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D017273:Goserelin / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008598:Menstruation; D008875:Middle Aged; D011184:Postoperative Period; D014592:Uterine Hemorrhage / Q000139:chemically induced; D055815:Young Adult
chemical_list: D017273:Goserelin; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: GnRH agonist; endometriosis; uterine bleeding