Acta Biomedica Scientia

COMPARISON OF LETROZOLE, NORETHISTERONE ACETATE, AND TRIPTORELIN FOR PAIN RELIEF IN PREMENOPAUSAL WOMEN WITH ENDOMETRIOSIS: A RANDOMIZED CONTROLLED TRIAL

Dr. Lakshmisri Atmuri

Endometriosis, Aromatase Inhibitors, Letrozole, Norethisterone Acetate, Triptorelin

In premenopausal women with endometriosis, the use of aromatase inhibitors necessitates additional medications to suppress gonadal estrogen biosynthesis. This study compared the efficacy and tolerability of Letrozole versus Norethisterone Acetate or Triptorelin in providing pain relief. Patients with rectovaginal endometriosis were administered Letrozole (2.5 mg/day) or Norethisterone Acetate for a duration of six months. Symptom assessment utilized both a visual analog scale and a multidimensional categorical rating scale, while virtual organ computer-aided analysis estimated endometriotic nodules. Adverse effects of treatment were also monitored. A total of 70 women were randomized into two treatment groups. In the Norethisterone Acetate group, 64.7% of patients reported satisfactory or very satisfactory treatment outcomes, compared to 22.2% in the Triptorelin group. Both treatment groups demonstrated significant reductions in pain intensity throughout the study duration, with no statistically significant difference between them. However, the Triptorelin group exhibited a more significant reduction in the number of endometriotic nodules compared to the Letrozole group. Adverse effects leading to treatment interruption were more common in the Triptorelin group, with eight women discontinuing treatment compared to one participant in the Norethisterone Acetate group. Additionally, six women in the Norethisterone Acetate group experienced adverse effects. Furthermore, a significant decrease in mineral bone density was observed in the Triptorelin group but not in the Norethisterone Acetate group. In conclusion, aromatase inhibitors effectively reduce endometriosis-related pain. Combining Letrozole with oral Norethisterone Acetate resulted in fewer side effects and a lower discontinuation rate compared to Triptorelin alone