Gangar K F, Stones R W, Saunders D, Rogers V, Rae T, Cooper S, Beard R W
Department of Obstetrics and Gynaecology, St Mary's Hospital Medical School, London, UK.
Br J Obstet Gynaecol. 1993 Apr;100(4):360-4. doi: 10.1111/j.1471-0528.1993.tb12980.x.
To assess whether GnRH analogues are effective in relieving pelvic pain and congestion and whether menopausal symptoms caused by GnRH analogues can be minimised by supplementation with low dose continuous combined hormone replacement therapy (HRT).
Open prospective study.
Tertiary referral clinic at a teaching hospital.
Twenty-one women with chronic pelvic pain.
Four months' therapy with goserelin 3.6 mg/month combined with continuous oestradiol valerate 1 mg daily and medroxyprogesterone acetate 5 mg daily.
Visual analogue scale for pain, menopausal symptoms, bleeding patterns, uterine area, endometrial status, oestradiol concentrations and venogram scores.
Amenorrhoea was maintained in all but two women. Endometrial atrophy was maintained despite HRT supplementation. Two women had moderate menopausal symptoms but none had severe symptoms. Significant reduction of uterine cross sectional area was maintained throughout the study. There was no significant relief of pain.
HRT supplementation of GnRH analogues abolishes menopausal symptoms and thus may improve patient acceptability. Potentially beneficial effects such as endometrial atrophy, reduction of uterine volume and amenorrhoea were not negated by HRT. This combination is not effective in the treatment of chronic pelvic pain and congestion.
评估促性腺激素释放激素（GnRH）类似物在缓解盆腔疼痛和充血方面是否有效，以及通过补充低剂量连续联合激素替代疗法（HRT）能否将GnRH类似物引起的绝经症状降至最低。
开放性前瞻性研究。
一家教学医院的三级转诊诊所。
21名患有慢性盆腔疼痛的女性。
使用戈舍瑞林3.6毫克/月，联合戊酸雌二醇每日1毫克和醋酸甲羟孕酮每日5毫克进行四个月的治疗。
疼痛视觉模拟评分、绝经症状、出血模式、子宫面积、子宫内膜状态、雌二醇浓度和静脉造影评分。
除两名女性外，所有女性均维持闭经。尽管补充了HRT，但仍维持子宫内膜萎缩。两名女性有中度绝经症状，但无严重症状。在整个研究过程中，子宫横截面积持续显著减小。疼痛未得到明显缓解。
补充GnRH类似物的HRT可消除绝经症状，从而可能提高患者的接受度。HRT并未否定子宫内膜萎缩、子宫体积减小和闭经等潜在有益效果。这种联合治疗对慢性盆腔疼痛和充血无效。
