IMR Press / CEOG / Volume 36 / Issue 1 / pii/1630635165465-2080911021

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 46 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Case Report
Complete remission of OC-resistant catamenial shoulder joint pain and inguinal pain associated with extraperitoneal endometriosis following personalized GnRH agonist therapy
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1 Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama (Japan)
Clin. Exp. Obstet. Gynecol. 2009, 36(1), 46–48;
Published: 10 March 2009
Abstract

Background: Patients with severe extraperitoneal endometriosis require rapid remission and cannot wait for the effects of oral contraceptive hormones (OCs) to appear. Case: We successfully achieved personalized gonadotropin-releasing hormone agonist (GnRHa) therapy for a patient with catamenial right shoulder joint pain and right inguinal pain associated with extraperitoneal endometriosis, which was completely unable to be suppressed by OCs. A total of 15 subcutaneous GnRHa depot injections over a period of 19 months was performed according to the serum estradiol and LH levels, in order to maintain long-term amenorrhea without any estrogen-deprivation effects. No recurrence of the catamenial symptoms has been observed for more than 35 months after the final GnRHa depot injection. Conclusion: Personalized GnRHa therapy should become the first-choice therapy for OCresistant inoperable extraperitoneal endometriosis.
Keywords
Endometriosis
GnRH agonist
Leuprolide acetate
Oral contraceptive
Shoulder joint pain
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