Vaginal danazol for women with rectovaginal endometriosis and pain symptoms persisting after insertion of a levonorgestrel-releasing intrauterine device

Abstract

Objective To evaluate the effectiveness of treatment with vaginal danazol in improving the pain symptoms caused by rectovaginal endometriosis that persist after insertion of a levonorgestrel-releasing intrauterine device (LNG-IUD). Methods This pilot observational study included 15 women with rectovaginal endometriosis and pain symptoms persisting after LNG-IUD insertion. Vaginal danazol (100 mg per day) was self-administered for 6 months. The intensity of pain symptoms and the volume of rectovaginal endometriotic nodules were evaluated. Results Twelve women were satisfied or very satisfied with the treatment. After treatment with vaginal danazol for 3 months, there was a significant decrease in the intensity of pain symptoms compared with their intensity before the administration of danazol. The intensity of pain symptoms decreased further at 6-month follow-up. The volume of the rectovaginal nodules decreased after treatment with vaginal danazol for 6 months (1.7 ± 0.8 cm 3) compared with the baseline volume (2.3 ± 0.9 cm 3; P < 0.001). Adverse effects of the treatment were minimal and well tolerated. Conclusion Although a placebo effect cannot be excluded, the results indicate that vaginal danazol decreases the severity of endometriosis-related pain symptoms after LNG-IUD insertion.