Serum levels of estradiol and follicle stimulating hormone, and vasomotor symptoms in Thai women receiving GnRH analogue before laparoscopic enucleation of endometriotic cysts

Abstract

Background : GnRH analogue can suppress serum estradiol (E₂₎ and follicle stimulating hormone (FSH) to menopause level before laparoscopic enucleation of endometriotic cysts.

Objective : To study the levels of E₂ and FSH, and vasomotor symptoms after GnRH analogue treatment in Thai women with endometriotic cysts.

Materials and Methods : During January, 2006 - December, 2007. Sixty women diagnosed as having endometriotic cysts, aged 15 – 44 years, were recruited into the study. Leuprolide acetate 3.75 mg was given intramuscularly at one month interval for 3 months. Serum levels of E₂ and FSH were tested at 0, 1, 2 and 3 months after GnRH analogue treatments. Thai version of Greene climacteric score was recorded at 0, 1, 2 and 3 months.

Results : The median (25^th percentile, 75^th percentile) of serum E₂ level decreased significantly from the baseline (0 months: 232.3 (82.0,446.2) pmol/L vs. 1 months : 18.4(0,44.9) pmol/L, 2 months: 31.7(0,58.6) pmol/L, 3 months: 0(0,54.2) pmol/L). The median (25^th percentile, 75th percentile) of serum FSH level decreased significantly from the baseline at 1,2 and 3 months. (0 months: 4.8(3.1,7.0) IU/L vs. 1 months: 2.2(1.3,3.5) IU/L, 2 months 2.8 (1.8,5.2) ,3 months 3.0(2.8,4.9) IU/L). Only 8.3% of women required sedative medication for vasomotor symptoms relief. The mean vasomotor symptoms scores were significantly higher than the baseline at 2 and 3 months period (0 months: 14.5 vs. 2 months: 20.0 and 3 months: 20.2). Most women had amenorrhea at 3 months period (93.3%).

Conclusion : Leuprolide acetate can suppress ovarian function after the first month of injection. Most women can stand the vasomotor symptoms. Amenorrhea was the most common menstrual patterns at 3 months after injection.