I would think that if symptoms return, your ovaries would start functioning again.
The following articles don't exactly indicate a problem with the ovaries, but rather lupus or fibromyalgia based on one case. At
the end, premature ovarian failure doesn't always get a cause identified, and in the last abstract, "Lupron was successful in
preventing ovarian failure."
What we really need is more of a medical researchers' trial to identify those women who have had problems with Lupron, and to
have that studied, more than what the Lupron Victims Network is doing. They have a list of articles concerning Lupron. Either
that, find different channels to work in to get the drug unapproved for endometriosis suppression. I think that there was less
than 100 cases of problems (deaths) in the Rezulin case, so it is doable.
--
Victoria
1: Fertil Steril 2002 Oct;78(4):699-704
Effect of prolonged gonadotropin-releasing hormone agonist therapy on the outcome of in vitro fertilization-embryo transfer in
patients with endometriosis.
Surrey ES, Silverberg KM, Surrey MW, Schoolcraft WB.
Colorado Center for Reproductive Medicine, Englewood, Colorado, USA. esurrey@colocrm.com
CONCLUSION(S): Prolonged use of GnRH agonist before IVF-ET in patients with endometriosis resulted in significantly higher
ongoing pregnancy rates than did standard controlled ovarian hyperstimulation regimens. No deleterious effect on ovarian
response was observed.
1: Menopause 2002 Jul-Aug;9(4):236-41
Comment in:
Menopause. 2002 Jul-Aug;9(4):224-6.
Prevention of bone loss and hypoestrogenic symptoms by estrogen and interrupted progestogen add-back in long-term GnRH-agonist
down-regulated patients with endometriosis and premenstrual syndrome.
Mitwally MF, Gotlieb L, Casper RF.
Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Samuel Lunenfeld Research Institute and Mount Sinai
Hospital, University of Toronto, Toronto, Ontario, Canada.
CONCLUSIONS: Long-term GnRH-agonist down-regulation is safe and effective when combined with HRT add-back. Furthermore, on the
basis of this small study, the low-dose pulsed progestogen, continuous estrogen HRT regimen seems to be safe for use as add-back
therapy in terms of bone health.
1: Obstet Gynecol 2002 May;99(5 Pt 1):709-19 Related Articles, Links
Prolonged GnRH agonist and add-back therapy for symptomatic endometriosis: long-term follow-up.
Surrey ES, Hornstein MD.
Colorado Center for Reproductive Medicine, Englewood, Colorado, USA. esurrey@colocrm.com
CONCLUSION: GnRH agonist and norethindrone acetate alone or combined with low-dose conjugated equine estrogens administered to
symptomatic endometriosis patients for 12 months provides extended pain relief and bone mineral density preservation after
completion of therapy.
1: Gynecol Obstet Invest 2001;52(4):217-22
Efficacy of every-other-day administration of conjugated equine estrogen and medroxyprogesterone acetate on
gonadotropin-releasing hormone agonists treatment in women with endometriosis.
Irahara M, Uemura H, Yasui T, Kinoshita H, Yamada M, Tezuka M, Kiyokawa M, Kamada M, Aono T.
Department of Obstetrics and Gynecology, University of Tokushima, School of Medicine, Tokushima, Japan.
irahara@clin.med.tokushima-u.ac.jp
These findings led to a conclusion that GnRH-a therapy added back by every-other-day administration of 0.625 mg CEE and 2.5 mg
MPA was a safe and effective treatment for Japanese women with endometriosis. Copyright 2001 S. Karger AG, Basel
1: Hum Reprod 2001 Nov;16(11):2399-402
Post-operative GnRH analogue treatment after conservative surgery for symptomatic endometriosis stage III-IV: a randomized
controlled trial.
Busacca M, Somigliana E, Bianchi S, De Marinis S, Calia C, Candiani M, Vignali M.
II Department of Obstetrics and Gynecology, University of Milano, Milan, Italy. auro.busacca@unimi.it
CONCLUSIONS: This study does not support the routine post-operative use of a 3 month course of GnRH analogue in women with
symptomatic endometriosis stage III-IV.
1: Clin Rheumatol 2001;20(2):150-2
Fibromyalgia developed after administration of gonadotrophin-releasing hormone analogue.
Toussirot E, Wendling D.
University Hospital Jean Minjoz, Besancon, France. eric.toussirot@ufc-chu.univ-fcomte.fr
We report the case of a woman treated with a gonadotrophin-releasing hormone analogue for endometriosis who developed typical
clinical features of fibromyalgia, with widespread musculoskeletal pain, sleep difficulties, neuropsychological complaints and
tender points on clininal examination. The gonadotrophin-releasing hormone analogue treatment probably induced disturbances in
the neuroendocrine system and the secretion of neurotransmitters, and may be suspected to be the cause of this case of
fibromyalgia.
1: J Womens Health Gend Based Med 2001 Mar;10(2):137-62
Medical and surgical therapies for pain associated with endometriosis.
Winkel CA, Scialli AR.
Department of Obstetrics and Gynecology, Georgetown University Hospital, Washington, DC 20007, USA.
Endometriosis is a common condition for which a number of treatments have been proposed. Medical treatments are based on the
hormonal responsiveness of endometriosis implants. These therapies include progestins (with or without estrogens), androgens,
and gonadotropin-releasing hormone (GnRH) analogs. Surgical treatments may include hysterectomy with oophorectomy or
organ-sparing surgery involving ablation or resection of visible lesions of endometriosis and restoration of pelvic anatomy.
There are no studies that directly compare the effectiveness or adverse effects of medical therapy and surgical therapy. Studies
on medical therapy compare different treatments with placebo or with other active treatments. Hormone-based therapies for
endometriosis show 80%-100% effectiveness in relief of pelvic pain over a 6-month course of therapy. Serious adverse outcomes
after medical therapy are unusual. Studies on surgical therapy are largely anecdotal, with noncomparative reports on a variety
of surgical methods. A few comparative surgical studies have been reported. Because of the noncomparative nature of many of the
surgical studies, the use of combinations of surgical procedures and techniques in the reported studies, and the reporting of
results from surgeons with an unusually high level of technical skill, the gynecological practitioner has little basis in the
literature for assessing the optimum surgical approach. Surgical complications are believed to be underreported and may be
related to how aggressive a surgical procedure is undertaken.
1: J Obstet Gynaecol Res 2000 Oct;26(5):325-31
A prospective randomized study comparing endocrinological and clinical effects of two types of GnRH agonists in cases of uterine
leiomyomas or endometriosis.
Takeuchi H, Kobori H, Kikuchi I, Sato Y, Mitsuhashi N.
Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan.
CONCLUSION: Leuprolide 1.88 induced pituitary down regulation more rapidly than buserelin MP. However the hypoestrogenic
symptoms such as hot flashes were more severe in cases treated with leuprolide 1.88 than in those treated with buserelin MP. Our
data confirm that the therapeutic efficacy of buserelin MP and leuprolide 1.88 are similar, with both being sufficient to treat
uterine leiomyomas and endometriosis.
1: Gynecol Endocrinol 2000 Oct;14(5):388-91
Altered sensitivity to anti-endometriosis medicines in an adenomyosis patient with thyroid dysfunction.
Tanaka T, Umesaki N, Ogita S.
Department of Obstetrics and Gynecology, Osaka City University Medical School, Japan.
We report the rare case of a patient with adenomyosis who showed thyroid dysfunction of unknown etiology during treatment for
endometriosis. She responded to nafarelin acetate and danazol when she was euthyroid but not to buserelin acetate when she was
hyperthyroid. This suggests that the response to anti-endometriotic medicine in our patient was altered by impaired thyroid
function and that this could occur in other such patients.
http://www.resolve.org/treatment/premature/premature.shtml
Premature ovarian failure is defined as the cessation of menstrual periods before the age of 40. It occurs in 1 in 1,000 women
between the ages of 15 and 29 and 1 in 100 women between the ages of 30 and 39. The average age of onset is 27 years. A family
history of POF is found in about 4% of the women experiencing the condition. Premature Ovarian Failure may occur abruptly over
one to two months or gradually over several years. Some women may experience symptoms of menopause such as hot flashes, no
menses, and vaginal dryness. Usually, if a woman has POF, she begins to have irregular periods eventually stop. Either her cycle
day 3 FSH or her estrogen levels may be elevated. In most cases of POF, no cause is ever identified. Pelvic surgery,
chemotherapy and radiation therapy can cause POF, as can uncommonly severe pelvic inflammatory disease. Premature ovarian
failure is a difficult and disturbing diagnosis for most women.
http://www.hopkins-arthritis.som.jhmi.edu/edu/acr2001/systemic-lupus.html
Leuprolide Acetate (Lupron)
Abstract #2006 Use of Leuprolide Acetate for Ovarian Protection During Cyclophosphamide Therapy of Women with Severe SLE: A Case
Control Study.
WJ McCune, E Somers, V Ognenovski, G Christman.
The risk of premature ovarian failure with cytoxan in women over the age of 35 is large (50% or more), and even younger women
have substantial risk.
At last year's ACR meeting Dr. Mary Ann Dooley presented the first prospective study of Lupron to protect fertility during
cytoxan induction. Basically, Lupron puts the ovaries at rest. The regimen is 3.75mg two weeks before each cytoxan bolus. In the
Dooley trial, Lupron was successful in preventing ovarian failure. Surprisingly, the women did not develop symptoms of estrogen
deficiency and did not require supplemental estrogen.
In a retrospective case-control study, McCune and colleagues suggested efficacy of Lupron (p=0.06). In contrast to Dooley,
supplemental estrogen was given to most patients (it is not clear whether this was triggered by symptoms or not).
Editorial Comment: We do not know if any of the women had contraindications to estrogen (i.e., hypercoagulability) or developed
severe flares afterwards.
From: anonymous@obgyn.net (BJ)
Jo,
I am assuming you are taking this drug to treat endometriosis? Has your
doctor ever explained it to you and told you how it works and how
dangerous it can be? Here is a quote from Dr. Albee's (endo specialist)
website about this drug (and the others in the same category): "Synarel
and Lupron (and Zoladex and RU-486) are excellent tools for creating a
drug-induced ovarian failure. These drugs work on the pituitary gland
to deplete it of all gonadotropins. When that happens, ovarian function
stops." Get it? It causes ovarian failure. What you are experiencing is
exactly what the drug is intended to do. Many women have a difficult
time getting their ovaries to function properly again after using these
drugs. I have never heard of anyone using these drugs as long as you
have. I think you should get a whole lot more information because you
may already have done irreparable damage to your ovaries. Good luck!
BJ
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