Metabolic changes during medical treatment of endometriosis: Nafarelin acetate versus danazol

In this double-blind study of changes in plasma lipid and lipoprotein concentrations during 6-month medical treatment of endometriosis, 53 patients were randomly assigned to one of four treatment schedules: danazol, 800 mg/day (n = 10); danazol, 600 mg/day (n = 8); intranasal nafarelin acetate, 800 μg/day (n = 10); or intranasal nafarelin acetate, 400 μg/day (n = 25). Plasma levels of triglycerides, cholesterol, and low-density lipoprotein, very low-density lipoprotein, and high-density lipoprotein cholesterol fractions were obtained before,'during, and 1 month after treatment. High-density lipoprotein, and high-density lipoprotein₃, cholesterol concentrations were measured in selected patients. Body weight was also followed. The drugs were equally effective in achieving symptomatic relief and laparoscopically demonstrated resolution of endometriosis but differed significantly in their effects on lipid concentrations. Nafarelin acetate had no adverse effects on serum lipoprotein concentrations, whereas danazol significantly decreased high-density lipoprotein cholesterol (p < 0.01), as well as the high-density lipoprotein₂ subtraction (p < 0.05), and increased low-density lipoprotein cholesterol (p < 0.01). Danazol significantly increased body weight (p < 0.01), whereas nafarelin did not.