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Re: GNRH agonists and adenomyosis From: Harvey S. Marchbein, M.D. (hmarchbein@worldnet.att.net) Mon Mar 31 19:12:34 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: hldnsj@top.monad.net: "Re: fetal monitoring during surgery" Previous message: Harrison Sheld: "Shrinking Violet" In reply to: Richard Chudacoff, MD: "GNRH agonists and adenomyosis" Next in thread: Kelly Shanahan: "Re: GNRH agonists and adenomyosis" At Mon, 31 Mar 1997, Richard Chudacoff, MD wrote: >My scope showed a normal pelvis, no evidence of endometriosis nor adhesions, >with bilateral flow through the normal appearing fallopian tubes. Her uterus >is slightly enlarged and globular. >Okay, here is the question. I believe she has adenomyosis, and I know she >wants to wait a year into her marriage before she gets pregnant. There are a >couple of reports about using GNRH agonists with adenomyosis for pain >control. Anyone out there have experience with this management, assuming >that paragraph 2 does not work? My thought is to use the GNRH agonist solo >for three months and if there is relief, then start with add back therapy >with the highest possible dose that does not cause a return of the pain. >Whatjathink? Only experience with GnRH agonists is with endometriosis and fibroids so I can't help there, but, two points. With chronic pelvic pain, I always consider sexual abuse at a younger age as a possible cause when she scopes negative. If all else fails, consider uterosacral nerve ablation. I've had modest (read 50/50) success with this approach. -- Harvey Harvel the Marvel Harvey S. Marchbein, M.D. FACOG, FACS President-elect Nassau Obstetrical and Gynecological Society, Inc. OBGYN.net U.S. Representative, New York http://www.obgyn.net/states/bios/marchbein.htm Private practice, Long Island, N.Y. ********************************* It's better to be lucky than to be smart. Even smart people can have an off day! ********************************* Next message: hldnsj@top.monad.net: "Re: fetal monitoring during surgery" Previous message: Harrison Sheld: "Shrinking Violet" In reply to: Richard Chudacoff, MD: "GNRH agonists and adenomyosis" Next in thread: Kelly Shanahan: "Re: GNRH agonists and adenomyosis"

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