Gonadotropin-releasing hormone analog combined with depot medroxyprogesterone acetate in the management of endometrial hyperplasia: A prospective randomized clinical study

Karakilic I. D., KARABACAK R. O., KARABACAK N., GÜLER İ., Korucuoglu U.

Journal of Reproductive Medicine, cilt.61, sa.4, ss.361-367, 2016 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 61 Sayı: 4
  • Basım Tarihi: 2016
  • Dergi Adı: Journal of Reproductive Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.361-367
  • Anahtar Kelimeler: Atypical endometrial hyperplasia, Depo-medroxyprogesterone acetate, Endometrial hyperplasia, GnRH analog, Heavy menstrual bleeding, Medroxyprogesterone acetate, Menstruation
  • Gazi Üniversitesi Adresli: Evet

Özet

© Journal of Reproductive Medicine®, Inc.OBJECTIVE: To compare the effectiveness of combined treatment of depot medroxyprogesterone acetate (MPA) with gonadotropin-releasing hormone (GnRH) analog and depot MPA alone in the management of simple endometrial hyperplasia without atypia among heavy bleeders. STUDY DESIGN: Thirty-four patients with endometrial hyperplasia without atypia were selected in this prospective randomized study. Group 1 consisted of 15 patients who were treated with depot MPA combined with GnRH analog. Group 2 consisted of 19 patients who were treated with depot MPA alone. Injections were applied at the beginning of the study and at the end of the 3rd month. Endometrial biopsies were performed at the end of the 6th month. Main outcome measures were endometrial response and reduction of duration and amount of menstrual bleeding. RESULTS: Total and mean duration of menstruation and total number of standardized pads used were significantly decreased in both groups. These parameters were also significantly lower in group 1 than in group 2 at the end of both the 3rd and 6th months of the study (p<0.01). Endometrial response rates were significant ly higher in group 1 than in group 2 (100% vs. 44.4%, respectively, p<0.05). CONCLUSION: Management of endometrial hyperplasia with GnRH analog in addition to depot MPA provides prompt endometrial response and rapid menstrual cycle control.