Therapeutic efficacy and bone mineral density response during and following a three-month re-treatment of endometriosis with nafarelin (Synarel)

Am J Obstet Gynecol. 1997 Dec;177(6):1413-8. doi: 10.1016/s0002-9378(97)70084-x.


Objective: Our goal was to determine the effects of a repeated course of the gonadotropin-releasing hormone agonist nafarelin on symptoms and signs of endometriosis and lumbar and distal radius bone mineral density.

Study design: Forty-five women previously treated for 6 months with nafarelin, who had recurrent symptoms and signs of endometriosis, received 400 mcg/day of nafarelin intranasally for 3 months. Efficacy was evaluated by changes in severity of symptoms and signs. Lumbar bone mineral density was measured by dual-energy x-ray absorptiometry and distal radius bone mineral density by single-photon absorptiometry. Bone mineral density was also measured in 10 control volunteers.

Results: Repeated 3-month treatment significantly alleviated recurrent symptoms and signs of endometriosis. Lumbar bone mineral density decreased significantly by a mean of 2% at the end of treatment; this loss was restored within 3 to 6 months after treatment completion. No bone mineral density decline occurred in the radius. Bone mineral density changes in the control group were statistically insignificant.

Conclusions: A repeated 3-month course of nafarelin treatment significantly relieved recurrent endometriotic symptoms and signs without sustained loss of bone mineral density.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bone Density*
  • Endometriosis / drug therapy*
  • Endometriosis / metabolism*
  • Estradiol / blood
  • Female
  • Hormones / adverse effects
  • Hormones / therapeutic use*
  • Humans
  • Menstrual Cycle / blood
  • Middle Aged
  • Nafarelin / adverse effects
  • Nafarelin / therapeutic use*
  • Recurrence
  • Retreatment
  • Treatment Outcome


  • Hormones
  • Nafarelin
  • Estradiol