The benefits of the standard drugs used to treat pain caused by endometriosis are improved when the woman is also treated with estrogen and progestin hormone therapy, Italian researchers report.

Endometriosis is an often-painful condition in which tissue that normally lines the uterus is found elsewhere in the abdomen. Drugs called gonadotropin-releasing hormone (GnRH) analogues are typically given in hopes of causing the tissue to shrink.

GnRH-analogue therapy has proven to be an effective treatment for endometriosis pain, but their use is often limited to 6 months because such drugs can cause low estrogen levels and associated problems, such as the bone-thinning disease osteoporosis.

Therefore, estrogen and progestin hormone therapy is sometimes given to prevent osteoporosis and allow for a longer treatment period.

In the present study, Dr. Marco Sbracia, from the Center for Endocrinology and Reproductive Medicine in Rome, and colleagues compared the outcomes of 46 women treated with a GnRH-analogue plus hormones, 44 treated with a GnRH-analogue alone, and 43 treated with an oral contraceptive for 12 months.

All of the women had undergone surgery for their endometriosis, but still experienced pain. The GnRH-analogue used was a drug called leuprolide acetate.

The investigators’ findings appear in the medical journal Fertility and Sterility.

The two treatments that involved the GnRH-analogue were comparable to each other and superior to oral contraceptive therapy in their ability to relieve pelvic pain, pain during menstruation, and pain during sexual intercourse.

In contrast, the GnRH-analogue plus hormones was better than the GnRH-analogue alone in terms of quality-of-life benefits and adverse effects.

The results indicate that a GnRH-analogue plus hormones “allows the treatment of women with relapse of endometriosis associated-pain for a long period more safely, with limited bone…loss, good control of symptoms, and better quality of life compared with the other two treatments,” the researchers conclude.

SOURCE: Fertility and Sterility, November 2004.