Postmenopausal endometrial hyperplasia: role of danazol therapy

Abstract

Although 17.1% of the women had a persistence of the hyperplasia and 8.4% of the symptom-free women relapsed after 4 months of follow-up, this experience confirms the effectiveness of danazol therapy in hyperplastic endometrial lesions. Nevertheless, a study comparing danazol and progestin therapy is required.

Treatment of Endometrial Hyperplasia with a Danazol-Releasing Intrauterine Device: A Prospective Study

“…Other studies have suggested danazol causes glandular atrophy and a pseudodecidual change of the endometrium [5,6,17]. We speculate in the present study that locally released danazol from the D-IUD had direct beneficial effects on endometrial hyperplasia through topical application due to the mechanism of diffusion and through a blood-borne mechanism due to the hypervascularity of the uterine cervix, and induced glandular atrophy and a pseudodecidual change of the endometrium.…”

“…Although the recurrence rate in the patients with endometrial hyperplasia (groups A and B) in the follow-up was 20%, this rate is acceptable as compared with other studies [8,16,17]. In addition, 2 patients conceived after removal of D-IUD.…”

“…Several drugs have been used in conservative therapy for endometrial hyperplasia, including danazol [2][3][4][5]17], progesterone [6,16] and a GnRH analogue [3,7]. Soh and Sato [4] reported that oral danazol is as effective, or more effective, than progesterone.…”

“…An estrogen-induced condition due to a prolonged and unopposed estrogenic stimulation is thought to be the main causative factor of endometrial hyperplasia [2]. In this respect, several drugs have been used in conservative therapy for endometrial hyperplasia, including danazol [2][3][4][5]17], progestin [6,16], gonadotropin-releasing analogues (GnRH-a) [3,7] and progestin-GnRH-a combined therapy [8]. In addition, as an alternative method to conservative medical therapy, a levonorgestrel-releasing intrauterine device proved to be effective for patients with dysfunctional uterine bleeding [9,10] and suppressed estrogen and progesterone receptors [11].…”

Danazol enhances Fas-mediated apoptosis in human endometrial epithelial cells within normal physiology

“…When danazol has been clinically applied to patients with functional uterine bleeding (24) or endometrial hyperplasia lesions (25)(26)(27)(28)(29)(30)(31), danazol may act on endometrial lesions by inhibiting endogenous estrogen and by progestin-like functions. However, during local danazol therapy it seems likely that unknown direct actions of danazol regulate endometrial cell growth locally and directly.…”