Postmenopausal osteoporosis: prevention and treatment with calcitonin

Pain recurrence: a quality of life issue in endometriosis

Studies reveal endometriosis to be present in 38-51% of women undergoing laparoscopy for chronic pelvic pain. Symptoms attributable to endometriosis include dysmenorrhea, dyspareunia, generalized pelvic pain, dyschezia, and radiation of pain to the back or leg. Psychological factors may also contribute to a more intense pain experience. Medical therapy provides symptom relief in 72-93% of patients, although recurrence is common following treatment discontinuation. Surgical therapy has had varying results for long-term pain relief; adequacy of the initial surgical treatment appears to be a critical factor. Important adjunctive measures include presacral neurectomy and excisional techniques to remove deep, fibrotic, retroperitoneal lesions. The quality of life of women with endometriosis will improve with greater focus on achieving the long-term relief of pelvic pain. Limitation of pain recurrence would benefit the patient greatly, by providing symptom relief and preventing the cycle of its probably adverse effects on physical activity, work productivity, sexual fulfilment, and mood.

Extending the use of gonadotropin-releasing hormone agonists: the emerging role of steroidal and nonsteroidal agents

OBJECTIVE

To review and summarize the state of the art as it relates to the long-term application of GnRH agonists (GnRH-a).

DESIGN

A retrospective analysis of the available literature and results and an up-to-date review of a rapidly evolving field.

CONCLUSION

Although the precise use of long-term GnRH-a therapy (in conjunction with sex steroid add-back therapy) remains unknown, the information provided strongly supports additional studies in this area to achieve a body of promising preliminary data.