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Re: GNRH agonists and adenomyosisFrom: Kelly Shanahan (mks@sierra.net)Mon Mar 31 22:11:33 1997
>31 yo G1P1 came to see me for a third opinion. ... She has intermittant menorrhagia (10-12 >days despite being on OCPS,) and severe dysmenorrhea, but her dull >persistant pelvic pain is present constantly. .... >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. > .... 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. .... 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? > >Rick > Rick I think your idea of using the GnRH agonist is very sensible. After all, if Lupron and the like work for endometriosis, which is endometrial glands & stroma outside the uterus, why shouldn't it work for adenomyosis, which is endometrial glands & stroma within the myometrium? Give it a shot. You and she have nothing to lose really. Kelly -- Kelly Shanahan, MD S. lake Tahoe, CA
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