A new therapy for pelvic endometriosis and uterine adenomyosis: local effect of vaginal and intrauterine danazol application.

In order to investigate the effect of the local direct action of danazol upon endometriosis, intravaginal and intrauterine application were tried. A vaginal danazol ring containing 2 g to 3.5 g danazol not only reduced both dysmenorrhea and the extent of pelvic endometriosis in all 35 infertile women, but also resulted in conception in 13 out of 35 infertile women while the vaginal ring was in place. Uterine adenomyosis usually fails to respond to oral danazol therapy, but an intrauterine device containing 175 mg of danazol was effective in reducing the size of the uterus and in inducing pregnancy in 66.6% cases. It is noteworthy that this vaginal or intrauterine danazol therapy did not inhibit ovulation, but still effected atrophy of endometriosis and aided in the establishment of pregnancy. These results clearly demonstrate that the main mode of action of danazol is its direct action on endometriotic cells.