A Comparison of the Skeletal Effects of Goserelin and Danazol in Premenopausal Women with Endometriosis

Abstract

The skeletal effects of two therapies for endometriosis that produce hypo-oestrogenism in 23 premenopausal women have been studied. Eleven women received goserelin 3.6 mg monthly by subcutaneous implant and 12 women received danazol 600 mg daily, orally, both for 6 months. Goserelin causes a small decline in spinal bone density, but a greater loss of density in the proximal femur. Preliminary results show no evidence that bone loss is reversible after stopping therapy. Danazol treatment is not associated with loss of bone. Prolonged or repeated courses of treatment with goserelin alone could lead to a clinically significant adverse effect on the skeleton.

Raloxifene Administration in Women Treated with Long Term Gonadotropin-releasing Hormone Agonist for Severe Endometriosis: Effects on Bone Mineral Density

“…Circulating estradiol levels decrease to the post-menopausal range, producing important menopausal side effects, such as a reduction in BMD at the lumbar spine2829 and proximal femur 30. Therefore, there is a need for the prevention of bone loss during long term treatment with GnRH-a.…”

Effect of Gonadotropin-Releasing Hormone Agonists on Bone Metabolism

“…In one study of the effects of a monthly depot injection of goserelin 3.6 mg, there was a significant decrease of -2% in spine density (DPA) together with a decrease of -1.7% in the femoral neck density; 34 in the other study a similar dose of goserelin produced a significant decrease of -4.88% in spine density (DEXA). 35 Two small studies with buserelin have been published.…”

“…23,24,27,28 Dual Energy Absorpiometry (DPA/DEXA) Eleven studies, eight performed with DPA and three with DEXA, and lasting 6 months, are included in this review. 23,24,[29][30][31][32][33][34][35][36] With the exception of one of the groups in one study, 24 all of the other studies showed a decrease in bone mineral density of the spine, from -0.8% to -6.0%. This large variation in the change in bone density could be explained by technical problems in densitometry measurement, by the degree of estrogen deficiency produced by several different analogues and doses, or possibly by the preexisting medical problem (Fig.…”

Uterine Fibroids: Literature Review and Summary of Posters

“…Stevenson et al [34] have measured bone density in 11 pre-menopausal women treated with Zoladex and found a significant decrease in the vertebrae and proximal femur; 6 months after cessation of therapy there was no recovery of the lost bone density in 9 women. In addition, Devogelaer et al [35] have measured bone density at different levels of the forearm during buserelin treatment and found that the analogue produces a highly significant selective loss of trabecular bone.…”