Use of Norethindrone Acetate Alone for Postoperative Suppression of Endometriosis Symptoms

• Published in: Journal of pediatric & adolescent gynecology Vol. 25; no. 2; pp. 105 - 108
• Main Authors: Kaser, D.J., MD, Missmer, S.A., ScD, Berry, K.F., MA, Laufer, M.R., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2012
• Subjects: Adolescent; Adult; Bleeding; Contraceptives, Oral, Synthetic - adverse effects; Contraceptives, Oral, Synthetic - therapeutic use; Endometriosis; Endometriosis - complications; Endometriosis - drug therapy; Endometriosis - surgery; Female; Humans; Metrorrhagia - etiology; Norethindrone - adverse effects; Norethindrone - analogs & derivatives; Norethindrone - therapeutic use; Norethindrone acetate; Obstetrics and Gynecology; Pediatrics; Pelvic pain; Pelvic Pain - etiology; Progesterone; Progestin-only; Retrospective Studies; Weight Gain; Young Adult; Endometriosis; Progesterone; Progestin-only; Pelvic pain; Bleeding; Norethindrone acetate
• ISSN: 1083-3188; 1873-4332
• DOI: 10.1016/j.jpag.2011.09.013

Abstract Study Objective To evaluate the efficacy and tolerability of norethindrone acetate (NA) as single-agent hormonal therapy for suppression of endometriosis symptoms in adolescents and young adults. Design Retrospective study. Setting Two academic medical centers. Participants A keyword search using the query ‘NA’ was applied to the electronic medical records of all women treated by one gynecologist (M.R.L.) from 1992 to 2010. IRB-approved chart review was then conducted on the index records. Interventions Continuous treatment with NA (5–15 mg daily). Main Outcome Measures Postoperative bleeding and pain scores; adverse effects. Results One hundred and ninety-four patients with surgically diagnosed endometriosis initiated NA postoperatively during the study period. Median patient age was 18.9 years. 92.2% of patients had stage 1 or 2 disease, and distribution was similar among those excluded. Median pain scores decreased from 5 at NA initiation to 0 at follow-up ( P = .0001) and bleeding scores from 2 to 0, respectively ( P = .001) for all stages of endometriosis. Post-NA bleeding scores were improved regardless of prior hormonal regimen, and post-NA pain scores improved in all patients except for those previously prescribed GnRH-agonist plus add-back. Most patients (55.2%) did not report any side effects. The most common adverse effect was weight gain (16.1%), with a mean increase in BMI of 1.2 ± 1.6 kg/m2 at 12 months. Conclusion NA alone is a well-tolerated, effective option to manage pain and bleeding for all stages of endometriosis. Among those on prior hormonal therapy, symptoms improved after NA initiation.