Oral Presentation
Objective -Gestrinone is a testosterone derivative with anti estrogenic , anti progesterone and androgenic properties . The objective of this study was to investigate the effect of low doses of gestrinone together with Miodesin™ in Pentravan™ on deep endometriosis pain .Methods –This study was carried out in 40 patients with deep endometriosis and severe pain treated vaginally with gestrinone associated with Miodesin™ in Pentravan™ . Miodesin™ is the brand name of a vegetal extract prepared from the Ungara tormentosa by Fagron(Netherland) and standardized to contain 4 % of oxindole alkaloids which are known to be potent inhibitors of NF-Kappa.b activation .Patient Intervention - The patients were divided in two groups . In group A (n=20) they were treated with a low dose of gestrinone in Pentravan™ (Fagron) (2,5 mg )twice a week administered vaginally . In group B (n=20)gestrinone was administered in the same dose together with Miodesin™ . Miodesin™ was used in the vagina daily in a dose of 500 mg in 3 ml of Pentravan . Patients in both groups were concomitantly treated orally with 100 mg of Pinus pinaster , 400 mg of Silimarin and 400 mg of Saw palmetto to diminish androgenic side effects and provide hepatic protection .Main Outcome Measure The main outcome investigated was the decrease in total pain scores evaluated by visual analogic scale (VAS) before and after two months of treatment Results Gestrinone in the lower dose of 2,5 mg significantly decreased total pain scores (VAS) in both groups . Before treatment they were 9 but after the second month pain scores decreased significantly to 3 and 0.8 in group A and B respectively .The difference between the groups was statistically significant (p=0.0002). There were also significantly more pain free patients in group B than in Group A (50%versus20%). Side effects were affecting 20% of the patients in both groups and consistent mainly in oily skin . Liver enzymes were not affected and SHBG levels decreased in both groups. Conclusion-These results suggest that vaginal Miodesin significantly increased the effectiveness of Gestrinone to treat pelvic pain in patients with deep endometriosis , rendering 80% of them pain free after the second month of treatment .