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Endometriosis therapy with medroxyprogesterone acetate.

Use of orally administered medroxyprogesterone acetate (MPA) 10 mg 3 times a day for 90 days was undertaken to assess its effect in patients with endometriosis. Subjects were 24 patients with symptoms of premenstrual pain suggestive of endometriosis. No patient had a large palpable adnexal mass. Patient interviews and pelvic and breast examinations were done before treatment at 30-day intervals during treatment and 30 days after treatment. Routine hematology urinalysis and blood chemistries were evaluated at the same periods. Endoscopic examinations were done before treatment and after 90 days of MPA therapy. Plasma progesterone was measured by radioimmunoassay at 2-week intervals during treatment and for 4 weeks after treatment. Endometrial biopsies were done in the pretreatment cycle and again on the last day of treatment. Symptomatic relief was total in 24 cases and improved in 3. In 1 case premenstrual pain recurred 11 months after treatment. Of 22 patients who had follow-up endoscopy examinations 15 had complete healing and 7 showed improvement. Plasma progesterone values showed ovulatory suppression during therapy and prompt restoration of ovulatory function later. Other examinations showed no significant changes. There were not drug-related side effects except occasional spotting. The MPA therapy was considered as somtimes palliative only but effective and preferable to other forms of medical management of endometriosis.