Fifty-one women with pelvic
endometriosis were treated with the
gonadotropin-releasing hormone agonist (GnRHa)
Buserelin (Hoechst Holland N.V., Amsterdam, The Netherlands) 300 micrograms three times a day intranasally for 6 months. Forty-nine women completed treatment; 42 were available for 6 months of follow-up following treatment. Symptoms showed prompt and significant improvement. Follow-up
after treatment revealed persistent relief from
dysmenorrhea and
dyspareunia in, respectively, 58.6% and 88.2% of the women, whereas
pelvic pain returned to pretreatment scores. Serum
estradiol (E2) was suppressed to predominantly early follicular phase concentrations. Laparoscopy at the end of
therapy showed significant reduction of scores for implants only. There was no relation between the degree of E2 suppression during
therapy and the improvement of symptoms or the reduction of
endometriosis. Statistical analysis in 22 infertile patients, of whom 7 conceived during follow-up, revealed no differences in E2 levels during
therapy, improvement of symptoms, or reduction of
endometriosis.
Buserelin appears to be safe, well tolerated, and effective in the management of
endometriosis and associated complaints.