Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0002453 (amenorrhea)
 6,245 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The induction of a state of hypo-oestrogenism has been found to be effective in the treatment of endometriosis. Continued administration of agonistic analogues of luteinizing hormone-releasing hormone (LHRH) results in the normal menstruating female developing normogonadotrophic-amenorrhoea with reduced circulating levels of oestradiol-17B, often within the menopausal range. Uncontrolled studies reported the efficacy of LHRH analogues in patients with mild, moderate and even severe endometriosis (American Fertility Society classification) following 6 months therapy. A number of large multi-centre randomized open or double blind trials comparing various LHRH analogues against danazol are currently underway. Published results available to date indicate that LHRH analogues and danazol are equally effective at reducing the symptoms of endometriosis and inducing complete or partial resolution of endometriotic deposits. Side-effects are, however, more severe with danazol therapy. The side-effects experienced with LHRH analogues are those expected from an induced state of hypo-oestrogenism--hot flushes, dry vagina, headaches, superficial dyspareunia--but are well tolerated by patients. The alterations observed in bone and calcium metabolism are comparable to those in the menopause--increased Ca++ loss and reversible loss of trabecular bone density have been reported. These effects may limit the duration and/or frequency of LHRH analogue treatment regimens. The valuable role of LHRH analogues in the treatment of endometriosis has been established and, as newer formulations become available, they are likely to play an increasingly important part in patient management.
 ...
PMID:LHRH analogues in the treatment of endometriosis--comparative results with other treatments. 306 68

The principal symptoms and signs of endometriosis are tissue lesions and pelvic pain. These occur to varying degrees, with a chronic pattern and a tendency for deterioration with time. Patients with endometriosis often also have fertility problems, but the relationship between this and the signs and symptoms of the disease is inconsequent; the basic pathophysiology is not exactly known. Although an immunological defect resulting in an inflammatory reaction around discharged menstrual debris in the pelvic cavity has been shown, no treatments based on this process are available. Estrogen often plays an important role in the progression of lesions and pain. Therefore, the aim of treatment usually has been to downregulate the ovaries and/or given antiestrogenic drugs as an alternative to surgical removal. As complete downregulation of the ovaries and hypoestrogenaemia does not seem to be crucial, achievement of amenorrhoea seems to be sufficient. This means that women may continue to have circulating estrogen levels so that severe hypoestrogenic adverse effects such as bone demineralisation, dry vagina, psychiatric symptoms or anabolic/androgenic effects of gestagens can be avoided. However, as both symptoms and the dependence of hormones may vary between and within women, the treatment needs to be individualised. There are a number of available treatments for endometriosis on the market and it is important for the doctor to know how to reach the therapeutic window of these treatments for each woman. It is also important to inform the patient about the different possibilities so that the treatment with the least impact on her quality of life can be chosen. When the therapeutic window has been identified, the treatment may then either be continued for a long period of time or be repeated when needed.
 ...
PMID:Current drug therapy recommendations for the treatment of endometriosis. 1043 28