Comparison of Outcomes of Different Postoperative Hormone Therapy in the Treatment of Ovarian Endometriosis: A Brief Report.

INTRODUCTION: Hormone therapy is widely used in the treatment of patients with ovarian endometriosis after surgery, and progestin and gonadotropin-releasing hormone (GnRH) are two of the most widely used hormones. This study aimed to compare the outcomes of progestin and GnRH in the treatment of ovarian endometriosis after surgery.

METHODS: A total of 399 patients with ovarian endometriosis were included and divided into four groups to receive different treatments. Group A received no postoperative hormone therapy; patients in group B1 and B2 were treated with different doses of norethindrone (progestin, 1.2 and 5 mg/day, respectively); patients in group C were treated with GnRH (2.0 mg every 2 weeks). Treatment outcomes including menstrual bleeding profiles, cumulative recurrence rate, incidence of complications, and endometrioma diameter in the case of recurrence were recorded and compared between groups.

RESULTS: Compared with group A, group B1, B2 and C showed significantly improved menstrual bleeding profiles and reduced cumulative recurrence rate and endometrioma diameter after recurrence. In addition, compared with group C, menstrual bleeding profiles were significantly improved and cumulative recurrence rate and endometrioma diameter were significantly reduced in group B1 and B2. No significant differences in incidence of complications during treatment were found among groups. After treatment, recurrence rate and endometrioma diameter were significantly increased in group B1, B2, and C.

CONCLUSION: Both progestin and GnRH can significantly improve the conditions of patients with ovarian endometriosis after surgery, but progestin may be a better choice. Both therapies are challenged by the increased recurrence rate and endometrioma diameter after treatment.