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.
Key Words
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Article info
Publication history
Published online: December 12, 2011
Footnotes
No authors have any conflicts of interest to disclose associated with this article.
Identification
Copyright
© 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
