Efficacy of vaginal danazol treatment in women with menorrhagia during fertile age

Objective: To evaluate the clinical efficacy and patient satisfaction of danazol delivered vaginally as treatment for young women with menorrhagia. Design: Prospective study. Setting: University of Siena, Siena, Italy. Patient(s): Women with menorrhagia (n = 55; age range 25-35 years) after ultrasound and hysteroscopy. Intervention(s): Low-dose danazol (200 mg/day) was daily administered by vaginal route for 6 months. Main Outcome Measure(s): Before and every month during the treatment women were requested: 1) to keep a diary of menstrual bleeding and to rate blood loss on a visual analog scale from 0 (no blood loss) to 10 (gushing-type bleeding); 2) to record side effects and their satisfaction with the therapy. Transvaginal ultrasound, blood count, serum chemistries, and serum concentration of LH, FSH, E-2, TSH, FT3, FT4, and PRL were evaluated before and after 6 months. Result(s): The severity of blood loss was significantly reduced in all of the women after 2 months of treatment. Uterine volume was significantly reduced, and hematocrit, hemoglobin, and red blood cell count increased in all of the women after 6 months. The medical treatment did not affect hormonal parameters, and menstrual cycle remained unaffected; few local vaginal adverse effects were recorded. Conclusion(s): Vaginal danazol resulted in effective medical treatment in young women with menorrhagia, and, because of a lack of significant adverse effects, it may be proposed as an alternative treatment. (Fertil Steril (R) 2009;92:1351-4. (C)2009 by American Society for Reproductive Medicine.)