Danazol for pelvic pain associated with endometriosis
- PMID:17943735
- DOI: 10.1002/14651858.CD000068.pub2
Danazol for pelvic pain associated with endometriosis
Abstract
Background: Endometriosis is defined as the presence of endometrial tissue (stromal and glandular) outside the normal uterine cavity. Conventional medical and surgical treatments for endometriosis aim to remove or decrease the deposits of ectopic endometrium. The observation that hyper androgenic states (an excess of male hormone) induce atrophy of the endometrium has led to the use of androgens in the treatment of endometriosis. Danazol is one of these treatments. The efficacy of danazol is based on its ability to produce a high androgen and low oestrogen environment (a pseudo menopause) which results in atrophy of the endometriotic implants and thus an improvement in painful symptoms.
Objectives: To determine the effectiveness of danazol compared to placebo or no treatment in the treatment of the symptoms and signs, other than infertility, of endometriosis in women of reproductive age.
Search strategy: We searched the Cochrane Menstrual Disorders and Subfertility Group Specialised Register of trials (searched April 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2007), and MEDLINE (1966 to April 2007). In addition, all reference lists of included trials were searched, and relevant drug companies were contacted for details of unpublished trials.
Selection criteria: Randomised controlled trials in which danazol (alone or as adjunctive therapy) was compared to placebo or no therapy. Trials which only reported infertility outcomes were excluded.
Data collection and analysis: Only five trials met the inclusion criteria and two authors independently extracted data from these trials. All trials compared danazol to placebo. Three trials used danazol as sole therapy and three trials used danazol as an adjunct to surgery. Although the main outcome was pain improvement other data relating to laparoscopic scores and hormonal parameters were also collected.
Main results: Treatment with danazol (including adjunctive to surgical therapy) was effective in relieving painful symptoms related to endometriosis when compared to placebo. Laparoscopic scores were improved with danazol treatment (including as adjunctive therapy) when compared with either placebo or no treatment. Side effects were more commonly reported in those patients receiving danazol than for placebo.
Authors' conclusions: Danazol is effective in treating the symptoms and signs of endometriosis. However, its use is limited by the occurrence of androgenic side effects.
Update of
- Danazol for pelvic pain associated with endometriosis.Selak V, Farquhar C, Prentice A, Singla A.Selak V, et al.Cochrane Database Syst Rev. 2001;(4):CD000068. doi: 10.1002/14651858.CD000068.Cochrane Database Syst Rev. 2001.Update in:Cochrane Database Syst Rev. 2007 Oct 17;(4):CD000068. doi: 10.1002/14651858.CD000068.pub2.PMID:11687066Updated.Review.
Similar articles
- Danazol for pelvic pain associated with endometriosis.Selak V, Farquhar C, Prentice A, Singla A.Selak V, et al.Cochrane Database Syst Rev. 2001;(4):CD000068. doi: 10.1002/14651858.CD000068.Cochrane Database Syst Rev. 2001.Update in:Cochrane Database Syst Rev. 2007 Oct 17;(4):CD000068. doi: 10.1002/14651858.CD000068.pub2.PMID:11687066Updated.Review.
- Danazol for pelvic pain associated with endometriosis.Selak V, Farquhar C, Prentice A, Singla A.Selak V, et al.Cochrane Database Syst Rev. 2000;(2):CD000068. doi: 10.1002/14651858.CD000068.Cochrane Database Syst Rev. 2000.Update in:Cochrane Database Syst Rev. 2001;(4):CD000068. doi: 10.1002/14651858.CD000068.PMID:10796483Updated.Review.
- Chinese herbal medicine for endometriosis.Flower A, Liu JP, Lewith G, Little P, Li Q.Flower A, et al.Cochrane Database Syst Rev. 2012 May 16;(5):CD006568. doi: 10.1002/14651858.CD006568.pub3.Cochrane Database Syst Rev. 2012.PMID:22592712Review.
- Gonadotrophin-releasing hormone analogues for pain associated with endometriosis.Brown J, Pan A, Hart RJ.Brown J, et al.Cochrane Database Syst Rev. 2010 Dec 8;2010(12):CD008475. doi: 10.1002/14651858.CD008475.pub2.Cochrane Database Syst Rev. 2010.PMID:21154398Free PMC article.Review.
- Danazol for heavy menstrual bleeding.Beaumont H, Augood C, Duckitt K, Lethaby A.Beaumont H, et al.Cochrane Database Syst Rev. 2007 Jul 18;2007(3):CD001017. doi: 10.1002/14651858.CD001017.pub2.Cochrane Database Syst Rev. 2007.PMID:17636649Free PMC article.Review.
Cited by
- Management Challenges of Deep Infiltrating Endometriosis.D'Alterio MN, D'Ancona G, Raslan M, Tinelli R, Daniilidis A, Angioni S.D'Alterio MN, et al.Int J Fertil Steril. 2021 Apr;15(2):88-94. doi: 10.22074/IJFS.2020.134689. Epub 2021 Mar 11.Int J Fertil Steril. 2021.PMID:33687160Free PMC article.Review.
- Defining a minimal clinically important difference for endometriosis-associated pelvic pain measured on a visual analog scale: analyses of two placebo-controlled, randomized trials.Gerlinger C, Schumacher U, Faustmann T, Colligs A, Schmitz H, Seitz C.Gerlinger C, et al.Health Qual Life Outcomes. 2010 Nov 24;8:138. doi: 10.1186/1477-7525-8-138.Health Qual Life Outcomes. 2010.PMID:21106059Free PMC article.Clinical Trial.
- Hormonal treatments for endometriosis: The endocrine background.Vannuccini S, Clemenza S, Rossi M, Petraglia F.Vannuccini S, et al.Rev Endocr Metab Disord. 2022 Jun;23(3):333-355. doi: 10.1007/s11154-021-09666-w. Epub 2021 Aug 17.Rev Endocr Metab Disord. 2022.PMID:34405378Free PMC article.Review.
- Measuring What Matters-A Holistic Approach to Measuring Well-Being in Endometriosis.McPherson L, Bhattacharya S.McPherson L, et al.Front Glob Womens Health. 2021 Dec 21;2:770366. doi: 10.3389/fgwh.2021.770366. eCollection 2021.Front Glob Womens Health. 2021.PMID:34993506Free PMC article.Review.
- Dienogest in long-term treatment of endometriosis.Schindler AE.Schindler AE.Int J Womens Health. 2011;3:175-84. doi: 10.2147/IJWH.S5633. Epub 2011 Jul 6.Int J Womens Health. 2011.PMID:21792339Free PMC article.
Publication types
MeSH terms
Substances
Related information
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous