Prolonged use of gonadotropin-releasing hormone agonist and tibolone as add-back therapy for the treatment of endometrial hyperplasia

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dc.contributor.authorAgorastos, T.en
dc.contributor.authorVaitsi, V.en
dc.contributor.authorPaschopoulos, M.en
dc.contributor.authorVakiani, A.en
dc.contributor.authorZournatzi-Koiou, V.en
dc.contributor.authorSaravelos, H.en
dc.contributor.authorKostopoulou, E.en
dc.contributor.authorConstantinidis, T.en
dc.contributor.authorDinas, K.en
dc.contributor.authorVavilis, D.en
dc.contributor.authorLolis, D.en
dc.contributor.authorBontis, J.en
dc.date.accessioned2015-11-24T18:56:06Z
dc.date.available2015-11-24T18:56:06Z
dc.identifier.issn0378-5122-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/18984
dc.rightsDefault Licence-
dc.subjectAdulten
dc.subjectDrug Therapy, Combinationen
dc.subjectEndometrial Hyperplasia/*drug therapy/pathologyen
dc.subjectEstrogen Receptor Modulators/*administration & dosageen
dc.subjectFemaleen
dc.subjectGonadotropin-Releasing Hormone/*agonistsen
dc.subjectHumansen
dc.subjectInjectionsen
dc.subjectLeuprolide/*administration & dosageen
dc.subjectMiddle Ageden
dc.subjectNorpregnenes/*administration & dosageen
dc.subjectTreatment Outcomeen
dc.titleProlonged use of gonadotropin-releasing hormone agonist and tibolone as add-back therapy for the treatment of endometrial hyperplasiaen
heal.abstractOBJECTIVES: To investigate the response of the various hyperplastic disorders of the endometrium to a prolonged treatment with leuprolide acetate, a gonadotropin-releasing hormone agonist (GnRH-a), plus tibolone, as add-back therapy, and further to study if the tibolone addition reduces the hypoestrogenic actions of the GnRH-analogue. METHODS: We treated 26 women with histologically confirmed simple (n = 9), complex (n = 15) or atypical (n = 2) endometrial hyperplasia (EH) for 12 months with monthly injections of 1Ampulle/3.75 mg of leuprolide acetate, followed by tibolone, 2.5mg per day per os. Every woman underwent a hysteroscopic evaluation and biopsy of the endometrium after 3 (in cases with atypical EH), 6 and 12 months of treatment, as well as after 12 and 24 months of follow-up. The clinical, paraclinical and laboratory course of the disease was followed-up by using of a climacteric scoring system and by testing of various parameters. RESULTS: The histopathologic evaluation of the endometria revealed regression of EH in all women after 12 months of treatment, however, during the first 2 years of follow-up EH reappeared in four women (4/21, 19%). Bone mineral density and serum parameters did not show significant changes during treatment, whereas only a mild suffering from hypoestrogenic side-effects was noted. CONCLUSIONS: It seems that the combined GnRH-a/tibolone treatment in women with EH is a potent alternative, so far as the endometrial status and the clinical course of the disease are concerned, whereas tibolone appears to act sufficiently as add-back therapy to prolonged GnRH-a treatment. The probability of relapse of the disease during the follow-up period makes the close monitoring of the endometrium after cessation of the treatment absolutely necessary.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1016/j.maturitas.2003.08.008-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/15172086-
heal.identifier.secondaryhttp://ac.els-cdn.com/S037851220300313X/1-s2.0-S037851220300313X-main.pdf?_tid=7740037473559da7cf450b5735c5e8a1&acdnat=1333540571_facf7cfd63c3458555279c9928516d0c-
heal.journalNameMaturitasen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2004-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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