GnRH Agonist Treatment for Endometriosis: Does the Type of Hormonal Add-Back Therapy Make a Difference?

Combination therapy with norethindrone acetate plus conjugated estrogens was more effective in building bone than norethindrone acetate alone.

Endometriosis often requires years of medical therapy (often in conjunction with surgery) to alleviate pain and preserve fertility. Gonadotropin-releasing hormone (GnRH) agonists are used for patients who fail first-line therapies, but the resulting hypoestrogenism can lower bone mineral density (BMD). This deleterious effect can be prevented with hormonal “add-back” therapy. In a randomized trial involving 51 women who were receiving GnRH agonist therapy for ongoing endometriosis pain, investigators evaluated norethindrone acetate (5 mg daily) plus conjugated equine estrogens (0.625 mg daily) versus norethindrone acetate plus placebo to compare the resulting effects on BMD.

Thirty-four women (age range at enrollment, 15–22) completed the 12…

Reviewing Author

Robert W. Rebar, MD

Disclosures

Consultant/Advisory BoardMyovant Sciences, Inc.

Editorial BoardsEndoText; Clinical OB/GYN Alert

Leadership Positions in Professional SocietiesAmerican Society for Reproductive Medicine (Member, Ethics Committee)

Robert W. Rebar, MD

Disclosures

Consultant/Advisory BoardMyovant Sciences, Inc.

Editorial BoardsEndoText; Clinical OB/GYN Alert

Leadership Positions in Professional SocietiesAmerican Society for Reproductive Medicine (Member, Ethics Committee)

GnRH Agonist Treatment for Endometriosis: Does the Type of Hormonal Add-Back Therapy Make a Difference?

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Reviewing Author