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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Danazol in a dose of 400 mg daily was administrated to 40 patients with chronic cystic mastitis and resulted in a marded improvement in both objective and subjective symptoms in 87.5% of the patients studied. Three patients showed partial relief of symptoms and 1 patient showed no improvement after 1 month of treatment at which time she withdrew from the study. One patient had a worsening of her condition and was withdrawn from the study after 3.5 months of therapy. Nineteen of the 40 patients in the study had a secondary diagnosis of pelvic endometriosis confirmed histologically, and all these patients showed a marked improvement of symptoms during the Danazol treatment. Patients developed amenorrhea after 3 to 4 months of Danazol therapy, and symptoms such as dysmenorrhea, premenstrual pelvic pain, and tension abated at the same time. A mild, but well-tolerated weight gain was the major side effect of Danazol administration. No significant changes in the levels of plasma E1, E2, FSH, LH, or progesterone could be demonstrated in specimens drawn from 11 patients before and during the course of Danazol administration.
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PMID:The effect of danazol in the treatment of chronic cystic mastitis. 94 22

The efficacy and safety of buserelin acetate in the treatment of endometriosis was studied in 4 open non-comparative trials and 2 open randomized comparative trials with danazol. 444 women were enrolled in the buserelin group and 89 in the danazol group. Treatment was for 6-10 months using 900-1200/micrograms intranasal buserelin/day and 400-800/micrograms oral danazol/day; patients were followed up for 6-8 months. Endometriotic lesions improved or disappeared in most women; pain (dysmenorrhoea, dyspareunia and pelvic pain) subsided rapidly. Most women had no, or alleviated, symptoms throughout follow-up, although ovarian function resumed promptly. Nearly a quarter of infertile women with a desire for children became pregnant. No significant differences between treatments emerged. Buserelin treatment was characterized by menopausal-like symptoms in most women, as well as by headache and nausea. Danazol treatment, which also gave rise to these effects, was accompanied by weight gain, myalgia and acne in a considerable proportion of women, as well as other anabolic and androgenic side effects. Buserelin would thus appear to be a safe and effective alternative to the standard therapy, danazol, in the treatment of endometriosis.
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PMID:Efficacy and safety of intranasal buserelin acetate in the treatment of endometriosis: a review of six clinical trials and comparison with danazol. 210 46

Endometriosis is an extremely common gynaecological disease, affecting between 1 and 5% of women of reproductive age. Women with endometriosis typically present for medical care with one of more of the following problems: pelvic pain, infertility, or a large adnexal mass (an endometrioma). The primary treatment for an endometrioma is surgical. However, long term postoperative hormone therapy may be necessary to prevent new endometriomas from developing. There is no evidence that hormonal therapy of endometriosis will improve fecundability in women with endometriosis and infertility. Pelvic pain due to endometriosis can be successfully treated with hormonal agents in the majority of patients. Four basic hormonal regimens are currently available for the treatment of endometriosis: (a) danazol; (b) gonadotrophin-releasing hormone (GnRH) [luteinising hormone-releasing hormone (LHRH); gonadorelin] agonists; (c) progesterones (progestins); and (d) combined estrogens and progesterones. Randomised, controlled, clinical trials suggest that danazol and the GnRH agonists are equally effective in the treatment of endometriosis. However, the side effects caused by danazol and the GnRH agonists are markedly different. Danazol produces androgenic side effects including weight gain, hirsutism, acne, oily skin and deepening of the voice. GnRH agonists produce side effects due to hypoestrogenism, including hot flushes, osteoporosis and dry vagina. The ideal drug regimen for the treatment of endometriosis remains to be developed.
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PMID:Endometriosis 1990. Current treatment approaches. 219 Jul 93

In order to evaluate the efficiency of Danazol treatment on pelvic endometriosis, a laparoscopic control with photographs was performed before treatment in 33 cases. Of these 20 were severe (group A), seven mild (group B) and six light (group C), according to the American Fertility Society classification, and 15 patients were infertile, 10 had pelvic pain and eight had dysmenorrhoea. Among the 28 patients who accepted a laparoscopic control after 6 months of treatment, the result was quite good in 50% of the cases in groups B and C, an improvement was seen in 30% of the patients in groups A and B, but a failure in 50% of the cases, especially in group A. Of the 14 cases with an ovarian cyst greater than 3 cm in diameter an operation was necessary either by laparoscopy (four cases) or by laparotomy (five cases). Seven pregnancies were established out of 15 cases of infertility, but a relapse was noticed in 30% of the cases. In conclusion, it appears that Danazol therapy is effective in mild or light endometriosis, but is not sufficient in cases of ovarian endometriosis with cysts greater than 3 cm in diameter.
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PMID:Laparoscopic control of danazol therapy on pelvic endometriosis. 296 11

The pathophysiology of endometriosis and its treatment are discussed. Endometriosis is a gynecological disorder characterized by the growth of the ectopic endometrium. The usual plaque looks like a small blood-filled cyst that is surrounded by a puckering scar. This tissue responds to fluctuating levels of hormones just as the normal endometrium does, and monthly bleeding of the cysts occurs followed by inflammation and scarring. Endometriosis may cause infertility, dyspareunia, dysmenorrhea, pelvic pain, and other menstrual problems. Therapy is chosen based on extent of disease, tolerance of side effects, and desire for pregnancy. Surgery is usually reserved for more extensive cases of the disease or if fertility is no longer desired. Induction of "pseudopregnancy" with estrogen-progesterone combinations has been used frequently; however, weight gain, initial exacerbation of pain, and the possibility of thromboembolism are limiting factors. Pseudomenopause, induced by danazol therapy, is an alternate method of treatment that causes a static endometrium. It offers rapid relief of symptoms to the majority of patients, and its most common side effects of weight gain and edema are reversible. Fertility rates after treatment are difficult to compare, but they appear to be similar for both hormonal therapies. Danazol has emerged as an effective alternative to the estrogen-progesterone combination treatment of endometriosis. Danazol may be prescribed before surgery to reduce lesions, following surgery to ablate any remaining lesions, or as the sole therapy for endometriosis.
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PMID:Pathophysiology and treatment of endometriosis. 703 70

A correct classification of female pelvic pain originating from gynaecological disorders is essential if the most appropriate therapy is to be chosen. Certain types of non-steroidal anti-inflammatory drugs and oral contraceptives reduce the production of prostaglandins, which are responsible in large part for primary dysmenorrhoea. Oestroprogestin formulations become the drugs of choice if the patient also requests contraception. Secondary dysmenorrhoea and chronic pelvic pain may require combined medical and surgical treatment. Oral contraceptives can also be used as post-treatment agents in endometriosis, one of the most common causes of pelvic pain, whereas more specific compounds (GnRH-analogues and Danazol) are used to produce anatomical regression of endometriosis.
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PMID:Chronic pelvic pain: oral contraceptives and non-steroidal anti-inflammatory compounds. 949 75

Medical treatment of endometriosis has been applied since 40 years. Its rational is based upon the hormone-dependency of the endometriotic lesions inducing a resting status. Adhesions, endometriomas or fibrous sequellae do not respond to medical treatment. Its use in case of associated infertility is very limited. Numerous agents are available for clinical use. Progestins are efficient on pelvic pain, contra-indications, clinical and metabolic tolerance are linked to the hormonal activity of the molecules. They have a low cost. Newer pills deserve to be evaluated. Danazol has now few indications in regards to its clinical and metabolic side-effects. Gn-RH analogs bear a potent efficacy and a very low intrinsic toxicity. They are preferentially used in severe cases, in association with surgery and before an IVF. Add back therapy improves the clinical tolerance and reduces bone mass loss. Many parameters should be taken into account when selecting a specific modality.
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PMID:[Medical treatment of endometriosis]. 1018 95

Chronic pelvic pain has a prevalence of 15% to 30% of reproductive-age women. It causes a sizable minority of all gynecological visits, and is responsible for much physical and psychological suffering. Although laparoscopic inspection, plus treatment, for pelvic pain has been considered ideal, it is often unnecessary, fruitless, and even hazardous, besides being expensive. Therefore, empirical medical therapy has much to recommend it. Foremost is the fact that endometriosis is the most frequent source of chronic pelvic pain, and responds well to medical treatment. In fact, GnRH analogs (agonists) used for 6 months can reduce AFS endometriosis scores by one-half, with cure rates at 5 years of three-fourths of responders who had minimal disease and one-third of responders with severe disease. Danazol and oral contraceptives plus NSAIDs have been used, too. The latter treatment is best reserved for cases involving dysmenorrhea. The objections to empirical treatment-lack of exact knowledge of the entity being treated and the potential of overlooking cancer-are discussed here in the context of pain treatment, with an emphasis on history taking, diagnostic imaging, and careful observation.
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PMID:Chronic pelvic pain: presumptive diagnosis and therapy using GnRH agonists. 1043 11

Laparoscopy is the most frequent surgical approach in gynecologic patients with acute or chronic pelvic pain. The symptomatology is frequently related to a specific gynecological pathology such as endometriosis or associated adhesive disease. During an eight year period, January 1990 to December 1997, 26 patients (aged 16-20 years) with endometriosis were diagnosed endoscopically and managed pharmaceutically in our clinic. The disease was evaluated and staged according to the American Society of Reproductive Medicine. The disease was evaluated as first stage in 16 patients (61.6%), as second stage in eight patients (30.8%), as third stage in one patient (3.8%) and as fourth stage in one patient (3.8%). Patients underwent adhesiolysis and management according to their laparoscopic findings. Postoperative pharmaceutical treatment (Danazol, GnRH analogues, Oral Contraceptives) was given. Patients were followed for the evaluation of the treatment. The efficacy of the combination of endoscopic and pharmaceutical management of the disease is discussed.
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PMID:Evaluation of combined endoscopic and pharmaceutical management of endometriosis during adolescence. 1045 44

Endometriosis is a common gynecologic disorder characterized by the presence of endometrial tissue outside the uterine cavity. Although no single theory can explain all cases of endometriosis, the most commonly accepted theory is Sampson's theory of retrograde menstruation. Retrograde menstruation occurs in 76 to 90% of women. The much lower prevalence of endometriosis suggests that additional factors determine susceptibility to endometriosis. Endometriosis is associated with changes in both cell-mediated and humoral immunity. Impaired natural killer cell activity resulting in inadequate removal of refluxed menstrual debris may play a role in the development of endometriotic implants. Moreover, although the peritoneal fluid of women with endometriosis contains increased numbers of immune cells, these seem to facilitate rather than inhibit the development of endometriosis. Macrophages that would be expected to clear endometrial cells from the peritoneal cavity appear to enhance their proliferation by secreting growth factors and cytokines. Although it is unclear whether these immunologic alterations induce endometriosis or are a consequence of its presence, they appear to play an important role in allowing endometriosis implants to persist and progress and contribute to the development of associated infertility and pelvic pain. Danazol and gonadotropin-releasing hormone (GnRH) agonists are commonly used for the medical treatment of endometriosis. These medications seem to down-regulate cellular and humoral immune responses concomitant with their effect on endometriotic implants. Immunomodulatory effects of danazol and GnRH agonists are likely to contribute to the observed clinical improvement associated with their use.
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PMID:Endometriosis: interaction of immune and endocrine systems. 1291 83


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