Effect Of GnRH-a On Bone Metabolism In The Treatment Of Endometriosis

Objective: To study GnRH-a in the treatment of endometriosis, according to whether the add-back estrogen, from bone formation and bone resorption observed bone metabolism, and further add-back estrogen to explore the best time and dose.Method: 42 patients with endometriosis are taken to retain reproductive function surgery, postoperative pathology were confirmed, were completed in the first time after the first 1-3 days of menstrual added GnRH-a 3.75mg, once every 6 weeks, have completed two courses of treatment, a total of 3 months. Within one month, according to whether add-back estrogen were randomly divided into A group and B group, A group for add-group, B group for non-added group. Respectively,before each added GnRH-a and one month after drug withdrawal measuring sex hormones and biochemical markers of bone metabolism. Including indicators of bone formation BALP (Bone Alkaline Phosphatase) and resorption indicators ICTP (I type I collagen cross-linked carboxy-terminal peptide).Results: All patients'FSH,LH,E2 were significantly lower after added in GnRH-a month. BALP did not change significantly, ICTP significantly increased (P<0.05). One month after drug withdrawal two group BALP no significant change,A group ICTP have decreased over the previous trend,but there is no statistical significant (P>0.05). B group have increased over the previous trend, there is no statistical significance (P>0.05).Conclusion: Application of GnRH-a treatment of endometriosis 1 months,Sex hormone levels in a peri-menopausal state,Patients have the corresponding peri-menopausal symptoms,A group of estrogen replacement therapy in perimenopausal symptoms after working better, bones and joints to ease pain symptoms, and review of the B group in the same period without significant improvement in symptoms. Proven add-back estrogen to improve bone metabolism status,In addition,Indicators of changes in bone resorption ICTP as early as indicators of changes in bone formation BALP,we can think ICTP is the early changes in bone metabolism events during GnRH-a treatment of endometriosis. At the same time, also further proves that GnRH-a treatment for bone metabolism changes is bone resorption more than bone formation.It's necessary that add-backed estrogen to those who have symptoms of pain in bone, without having to be postponed to when with GnRH-a 3-month.