Quality of life according to add-back therapy during GnRH agonist treatment in endometriosis patients

Joo, Jong Kil; Jung, In Kook; Kim, Ki Hyung; Lee, Kyu Sup

Abstract

OBJECTIVE
This study was performed to investigate the effect of add-back therapy on quality of life during postoperative gonadotropin-releasing hormone (GnRH) agonist therapy for endometriosis.
METHODS
Fifty-one patients who were diagnosed as stage III/IV endometriosis after laparoscopic ovarian cystectomy from January 2009 to December 2010 were divided into GnRH agonist with add-back therapy group and GnRH agonist only group. Add-back therapy was started before third injection of GnRH agonist. Short form health survey (SF-36) instrument was checked preoperatively, at the time of 6th GnRH agonist therapy and 6 months after GnRH agonist therapy.
RESULTS
There were no differences between two groups on the mean age, body mass index and revised American Fertility Society score. In most cases, add-back therapy was added because of menopausal symptoms. Pelvic pain and dysmenorrhea showed no differences between two groups on each survey period. At the time of 6th GnRH agonist therapy, physical function in add-back therapy group was improved significantly compared with preoperative period (85.7+/-8.8 vs. 91.0+/-10.4, P=0.011). In GnRH only group, physical function at preoperative period was rather higher than at the time of 6th GnRH agonist therapy.
CONCLUSION
Add-back therapy during postoperative GnRH agonist therapy showed no negative effect on pelvic pain and dysmenorrhea. Physical function was improved in add back group. Add-back therapy might have an influence on quality of life in patients receiving postoperative GnRH agonist therapy for endometriosis.