High-Dose Medroxyprogesterone Acetate and Danazol in the Treatment of Endometriosis

Studies on cytosol endometrial estrogen and progestin receptor concentrations and 17s-hydroxysteroid dehydrogenase activity have shown that the effects of danazol and medroxyprogesterone acetate (MPA) are similar. Therefore we conducted a placebo-controlled study to compare danazol (600 mg/day) and MPA (100 mg/day) in the hormonal treatment of mild-moderate endometriosis. The duration of treatment was 6 months. Laparoscopy was performed before the trial and 6 months after the treatment. Sixteen patients receiving MPA, 18 patients receiving danazol and 17 receiving placebo completed the study. The resolution of the peritoneal endometriosis implants was similar in the MPA (63%) and danazol (60%) groups, results differing significantly from the placebo effect (18%). MPA and danazol significantly alleviated endometriosis-associated pelvic pain, lower back pain and defecation pain and they did not differ from each other. In comparison with placebo, MPA appeared to be less androgenic than danazaol, while anabolic side effects were similar. High-dose MPA is thus a useful alternative in the hormonal treatment of endometriosis.