Nafarelin versus danazol in the treatment of endometriosis

Article Abstract:

Endometriosis is a gynecological complication that develops when the cells normally lining the uterus, the endometrial cells, grow and function in other locations in the body. Endometrial cells respond to estrogen, which is produced in the ovaries, as if they were located inside the uterus. The most common complaints of endometriosis are pelvic pain, severe pain during menstruation, pain during intercourse, and infertility. The aim of treatment is to suppress estrogen production and thereby shrink endometrial tissue. Nafarelin is a drug that mimics gonadotropin-releasing hormone, which is produced by glands in the brain. The ovaries initially increase production of estrogen. This is followed by a severe reduction of estrogen and endometrial tissue shrinkage. Danazol is a male hormone (androgen) that takes the place of estrogen on receptors on the surface of endometrial cells, creating a hostile environment for endometrial tissue: low estrogen and high androgen. Nafarelin (200 micrograms twice a day) or danazol (200 mg twice a day) was given to 194 patients (aged 18 to 45 years) with endometriosis. The symptoms were scored by their severity, from mild to severe. The two drugs were found to be equally effective in treating endometriosis. Symptoms disappeared in 57 percent of the women receiving nafarelin and 48 percent of the women receiving danazol. A similar number of patients stopped menstruating in both treatment groups. Side effects of nafarelin treatment caused by the decreased estrogen were hot flashes, vaginal dryness and decreased sex drive. Danazol treatments produced muscle pain, nervousness, weakness, gastrointestinal pain and a significant weight gain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Danazol

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Nafarelin in the treatment of infertility caused by endometriosis

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. Infertility associated with endometriosis is not well understood. The abnormally placed endometrial tissue creates an environment unsuitable for pregnancy. Treatment can include surgery, drugs or no treatment. Nafarelin is pharmacologically similar to gonadotropin-releasing hormone, a hormone released by glands in the brain that stimulate the ovaries to produce estrogen. Nafarelin initially increases estrogen production by the ovaries, followed by a decrease in production two weeks later. When the ovaries are stimulated, they release estrogen. Since endometrial cells respond to hormones produced by the ovaries, by inhibiting the production of estrogen endometrial tissue can not respond. It is suggested that patients without pain should not be treated with surgery or drugs. In a study of fertility after surgery, the pregnancy rate was two percent. Danazol is a male hormone (androgen) used to suppress the production of estrogen. The monthly pregnancy rate after nafarelin therapy was also two percent and 0.9 percent after danazol. Therefore, the fertility rate after nafarelin therapy was similar to that after surgery. A study comparing the use of danazol and nafarelin in the treatment of infertility caused by endometriosis is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Infertility, Female, Female infertility

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