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Evidence summaries

Danazol in the Treatment of Endometriosis

Danazol appears to be effective in treating the symptoms and signs of endometriosis. However, its use is limited by the occurrence of androgenic side effects. Level of evidence: "B"

A systematic review [Abstract] 1 included 5 studies with a total of 370 patients. Treatment with danazol (including adjunctive to surgical therapy) was effective in relieving painful symptoms related to endometriosis when compared to placebo. Laparoscopic scores were improved with danazol treatment (including as adjunctive therapy) when compared with either placebo or no treatment. Side effects were more commonly reported in patients receiving danazol than placebo.

Only one study without surgery in the review recorded symptoms as an outcome 2. This study found a significant decrease in the levels of pelvic pain, lower back pain, defecation pain and total pain (total score for all pain symptoms) in patients treated with danazol compared to those treated with placebo at three and six months of therapy and six months after medication. However, no significant difference was found between the two groups in terms of the degrees of dysuria and dyspareunia. Two studies with surgery reported on improvement in pain symptoms; one 3 found a significant decrease in total pain in patients treated with danazol compared to those treated with placebo at six months of therapy and after 6 months off therapy with danazol. However, no significant difference was found between the two groups in lower back pain, defecation pain, dysuria and dyspareunia.

Comment: The quality of evidence is downgraded by sparse data.

    References

    • Selak V, Farquhar C, Prentice A, Singla A. Danazol for pelvic pain associated with endometriosis. Cochrane Database Syst Rev 2007 Oct 17;(4):CD000068. [PubMed]
    • Telimaa S, Puolakka J, Rönnberg L, Kauppila A. Placebo-controlled comparison of danazol and high-dose medroxyprogesterone acetate in the treatment of endometriosis. Gynecol Endocrinol 1987 Mar;1(1):13-23. [PubMed]
    • Telimaa S, Rönnberg L, Kauppila A. Placebo-controlled comparison of danazol and high-dose medroxyprogesterone acetate in the treatment of endometriosis after conservative surgery. Gynecol Endocrinol 1987 Dec;1(4):363-71. [PubMed]

Primary/Secondary Keywords