Endocrine responses to long-term administration of the antiprogesterone RU486 in patients with pelvic endometriosis.

OBJECTIVE

To examine endocrine and clinical responses to long-term administration of RU486 in patients with endometriosis.

DESIGN

Prospective open trial.

SETTING

Faculty practice of the authors.

PATIENTS, PARTICIPANTS: Six normally cycling women with endometriosis were recruited.

INTERVENTIONS

Subjects received RU486 100 mg/d for 3 months.

MAIN OUTCOME MEASURE(S): Hormonal changes during RU486 were compared with control data obtained in the preceding cycle during the early follicular phase. Clinical responses were determined by patient assessment and second-look laparoscopy.

RESULTS

All women became amenorrheic, and daily urinary levels of ovarian steroid metabolites remained acyclic. Mean luteinizing hormone (LH) (P less than 0.02) and LH pulse amplitude (P less than 0.05) were increased without changes in LH pulse frequency. An antiglucocorticoid effect was demonstrated by an increase in serum cortisol (P less than 0.01) and adrenocorticotropic hormone (P less than 0.05) levels. Treatment resulted in an improvement in pelvic pain in all subjects without significant change in the extent of disease as evaluated by follow-up laparoscopy.

CONCLUSIONS

Daily administration of RU486 results in acyclic ovarian function and improvement in the subjective painful symptoms of endometriosis.