Remorgida Valentino, Abbamonte Luiza Helena, Ragni Nicola, Fulcheri Ezio, Ferrero Simone
Department of Obstetrics and Gynaecology, San Martino Hospital and University of Genoa, Genoa, Italy.
Aust N Z J Obstet Gynaecol. 2007 Jun;47(3):222-5. doi: 10.1111/j.1479-828X.2007.00722.x.
It has recently been suggested that aromatase inhibitors may effectively reduce pain symptoms related to the presence of endometriosis both in postmenopausal women and in subjects of reproductive age.
This study aims to evaluate the effectiveness of a combination of letrozole and desogestrel in the treatment of pain symptoms related to the presence of endometriosis.
This open-label prospective study included 12 women with endometriosis-related pain symptoms that were refractory to previous medical and surgical treatments. All women had previous laparoscopy documenting stage IV endometriosis. The treatment protocol included the daily oral administration of letrozole 2.5 mg (Femara), desogestrel 75 microg (Cerazette), elemental calcium 1000 mg and vitamin D 880 I.U. The scheduled treatment period was six months.
None of the women included in the study completed the six-month treatment because all patients developed ovarian cysts; the median length of treatment was 84 days (range, 56-112). At interruption of treatment, all women reported significant improvements in dysmenorrhoea and dyspareunia. Pain symptoms quickly recurred at three-month follow up. There were no severe adverse effects of treatment; no significant change in the mineral bone density was observed during treatment.
The combination of letrozole and desogestrel induces a relief of pain symptoms in women with endometriosis but it causes the development of ovarian cysts. Pain symptoms quickly recur after the completion of treatment.
最近有研究表明，芳香化酶抑制剂可能有效减轻绝经后女性和育龄期女性与子宫内膜异位症相关的疼痛症状。
本研究旨在评估来曲唑和去氧孕烯联合用药治疗与子宫内膜异位症相关疼痛症状的有效性。
这项开放标签的前瞻性研究纳入了12名有与子宫内膜异位症相关疼痛症状的女性，这些症状对先前的药物和手术治疗均无效。所有女性之前都接受过腹腔镜检查，确诊为IV期子宫内膜异位症。治疗方案包括每日口服2.5毫克来曲唑（芙瑞）、75微克去氧孕烯（优思明）、1000毫克元素钙和880国际单位维生素D。预定治疗期为六个月。
研究纳入的女性中无人完成六个月的治疗，因为所有患者都出现了卵巢囊肿；治疗的中位时长为84天（范围56 - 112天）。在治疗中断时，所有女性均报告痛经和性交疼痛有显著改善。在三个月的随访中，疼痛症状迅速复发。治疗没有严重的不良反应；治疗期间未观察到骨矿物质密度有显著变化。
来曲唑和去氧孕烯联合用药可缓解子宫内膜异位症女性的疼痛症状，但会导致卵巢囊肿的形成。治疗结束后疼痛症状迅速复发。
