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, E2, 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.