Efficacy of letrozole in treatment of endometriosis-related pain

ObjectiveTo evaluate the efficacy of aromatase inhibitor (letrozole) in the treatment of endometriosis-related pain.Patients and methodA total of 20 women with Stage IV endometriosis presented with endometriosis-related pain refractory to previous treatment or recurrence after such treatment have been included in the study. All women were treated with oral administration of letrozole 2.5 mg in addition to elemental calcium 1000 mg and vitamin D 880 IU daily for a total treatment duration of 6 months. Baseline (pre-treatment), monthly during treatment, at end of treatment and 6 months after completion of treatment; all patients were evaluated for the presence and intensity of pain (including dysmenorrhea, deep dyspareunia and chronic pelvic pain) using a 100 mm visual analog scale (VAS).ResultsMean age was 30.9 years with 80% of patients were NP. Half of patients presented with dysmenorrhea. Patients previously received oral contraceptives (50%), GnRH agonists (25%) and Medroxyprogesterone acetate (25%) or underwent laparotomy with ovarian cystectomy (20%) or exploration 30%). At the end of treatment (6 months after start treatment) mean VAS dropped from 7.65 at start of therapy to 6.1 (p-value < 0.005). Six months later (12 months after start of therapy), further significant drop of mean VAS has been reported (from 6.1 to 4).ConclusionLetrozole (aromatase inhibitor) has shown to be effective in the treatment of endometriosis-related pain with substantial improvement of pain with no recurrence of pain for 6 months after completion of treatment.