Serum estradiol and danazol. I. Endometriosis response, side effects, administration interval, concurrent spironolactone and dexamethasone

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Serum estradiol (E 2 ) levels and resolution of endometriosis were evaluated in 42 women after 75 days of danazol treatment. Complete or almost complete remission occurred when radioimmunoassay E 2 levels were < 15 pg/ml in extensive, < 22 pg/ml in severe, and < 41 pg/ml in moderate endometriosis. E 2 ≤ 20 pg/ml occurred in 23% of 104 patients given 400 mg every 12 hours but in none weighing over 150 pounds (68 kg). E 2 > 100 pg/ml occurred in 7%. The mean E 2 levels were identical with 400 mg every 12 hours and 200 mg every 8 hours. The E 2 level was 40% lower with 200 mg every 6 hours than with 400 mg every 12 hours ( P < 0.001). Dexamethasone further decreased E 2 levels by 61% ( P < 0.001). Spironolactone decreased androgen symptoms but increased E 2 levels by 49% ( P < 0.01).