Comparison of the pharmacology of nafarelin and danazol

Article Abstract:

Endometriosis is a gynecological complication that develops when the cells that normally line the uterus, the endometrial cells, grow and function in other locations in the body. It is thought that backward flow of menstrual blood carries endometrial tissue that seeds in a variety of areas in the pelvic structures. Endometrial cells respond in the presence of estrogen, which is produced by the ovaries, as if they were located inside the uterus. The aim of treatment is to suppress estrogen production. Danazol is a male steroid hormone (androgen) that can occupy the receptors on endometrial cells that are intended specifically for estrogen. When danazol takes the place of estrogen, the cells then function as if the receptors were designed for the androgen. Danazol creates a hostile environment for endometrial tissue: low estrogen and high androgen. The endometrial tissue is suppressed and the tissue shrinks. Reseeding of endometrial tissue is prevented because menstruation stops. Danazol increases the less desirable low density lipoprotein (LDL) and decreases the more desirable high density lipoproteins (HDL). It takes one to five months for lipoprotein ratios to normalize once therapy is discontinued. Liver enzymes are increased with danazol use. Nafarelin is a drug that mimics the gonadotropin-releasing hormone released by glands in the brain. Initially, the gonadotropin-releasing hormone increase stimulates the production of estrogen by the ovaries. This is followed by a suppression of ovarian production of both estrogen and progesterone. Nafarelin results in a marked decrease in estrogen. Estrogen protects women from bone reabsorption and decreased bone density. There is a small, but reversible, decrease in bone density with nafarelin therapy. Danazol doses not affect bone density. Although both drugs are able to decrease the pain associated with endometriosis, danazol users have severe weight gain and bloating, and can develop deep voices, acne, oily skin and hair growth, symptoms not found with nafarelin use. Nafarelin produces hot flashes, vaginal dryness and decreased libido (sex drive). (Consumer Summary produced by Reliance Medical Information, Inc.)

Danazol

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Gonadotropin-releasing hormone analogs in the treatment of endometriomas

Article Abstract:

Endometriosis is a gynecological complication that develops when the endometrial cells, which normally line the uterus, grow and function in other locations in the body. An endometrioma is a noncancerous mass of endometrial tissue. Gonadotropins are hormones released from glands in the brain that stimulate the ovaries to produce estrogens. Since endometrial tissue responds to estrogen, drugs that reduce the amount of estrogen by inhibiting the release of gonadotropin releasing hormones, may eliminate the need for surgical removal of endometriomas. Drugs mimicking the action of gonadotropin-releasing hormone, which include the drugs nafarelin, buserelin and histrelin, were compared with danazol, a male hormone (androgen) used to suppress the production of estrogen. Of the studies conducted thus far, gonadotropin-releasing hormone agonists for the treatment of endometriomas on the ovaries are as effective as treatment with danazol, particularly when the tissue is smaller than 0.39 inches (one centimeter). Larger endometriomas were reduced in size. It is noted that the research did not specifically study the effects of gonadotropin-releasing hormone agonists, but included a small number of patients with unconfirmed ovarian endometriomas. It is not known whether the growths return after therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Ovaries, Gonadotropin, Gonadotropins, Ovarian cysts

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Similar abstracts:

• Abstracts: A placebo-controlled trial of a depot gonadotropin-releasing hormone analogue (leuprolide) in the treatment of uterine leiomyomata
• Abstracts: Efficacy and safety of nafarelin in the treatment of endometriosis. Nafarelin in the treatment of pelvic pain caused by endometriosis
• Abstracts: Nafarelin versus danazol in the treatment of endometriosis. Nafarelin in the treatment of infertility caused by endometriosis

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