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Cited by 210Endometriosis Research and TreatmentMenstrual Health and DisordersEctopic Pregnancy Diagnosis and Management

Danazol for pelvic pain associated with endometriosis

Open access
Farquhar, Cindy, Prentice, Andrew, Singla, Amita A, Selak, Vanessa·2007·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd000068.pub2PMC PMC12740266
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Abstract

BACKGROUND: Endometriosis is defined as the presence of endometrial tissue (stromal and glandular) outside the normal uterine cavity. Conventional medical and surgical treatments for endometriosis aim to remove or decrease the deposits of ectopic endometrium. The observation that hyper androgenic states (an excess of male hormone) induce atrophy of the endometrium has led to the use of androgens in the treatment of endometriosis. Danazol is one of these treatments. The efficacy of danazol is based on its ability to produce a high androgen and low oestrogen environment (a pseudo menopause) which results in atrophy of the endometriotic implants and thus an improvement in painful symptoms. OBJECTIVES: To determine the effectiveness of danazol compared to placebo or no treatment in the treatment of the symptoms and signs, other than infertility, of endometriosis in women of reproductive age. SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Subfertility Group Specialised Register of trials (searched April 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2007), and MEDLINE (1966 to April 2007). In addition, all reference lists of included trials were searched, and relevant drug companies were contacted for details of unpublished trials. SELECTION CRITERIA: Randomised controlled trials in which danazol (alone or as adjunctive therapy) was compared to placebo or no therapy. Trials which only reported infertility outcomes were excluded. DATA COLLECTION AND ANALYSIS: Only five trials met the inclusion criteria and two authors independently extracted data from these trials. All trials compared danazol to placebo. Three trials used danazol as sole therapy and three trials used danazol as an adjunct to surgery. Although the main outcome was pain improvement other data relating to laparoscopic scores and hormonal parameters were also collected. MAIN RESULTS: 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 those patients receiving danazol than for placebo. AUTHORS' CONCLUSIONS: Danazol is effective in treating the symptoms and signs of endometriosis. However, its use is limited by the occurrence of androgenic side effects.

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  • Danazol use was stopped due to unacceptable masculinizing side effects.

    “but its use was stopped due to unacceptable masculinizing side effects.”

    From Steroid hormone profiling reveals altered adrenal androgen production in endometriosis (2026) · cites this paper as [20]

    The paper’s summary says danazol produces male characteristics and that its side effects can be unacceptable. The Implications for research section says its side-effect profile makes it an unpopular choice, but neither passage says danazol use was stopped because of those effects. The summary’s reference to treatment being stopped describes the end of a treatment course, not discontinuation of danazol use generally. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Danazol is effective in treating endometriosis-related pain.

    “Danazol is effective in treating endometriosis-related pain [220] and its efficacy seems to persist also after the discontinuation of therapy [215].”

    From Hormonal treatments for endometriosis: The endocrine background (2022) · cites this paper as [220]

  • The synthetic androgen danazol was found to reduce endometriosis-associated pain.

    “Previously, the synthetic androgen danazol was found to reduce endometriosis-associated pain,20”

    From Steroid hormone profiling reveals altered adrenal androgen production in endometriosis (2026) · cites this paper as [20]

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Authors
Farquhar, C., Prentice, A., Singla, A. A., & Selak, V.
Affiliations
  • University of Auckland (NZ)
  • Rosie Hospital (GB)
  • Queen Elizabeth Hospital (AU)
  • Waitemata District Health Board (NZ)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2007-10-17
Volume
2010
Issue
11
Pages
CD000068-CD000068
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd000068.pub2
PMC
PMC12740266
OpenAlex
W1523117771
Cited by
210
References
24
Citations by year
2026: 4 · 2025: 6 · 2024: 9 · 2023: 8 · 2022: 10 · 2021: 13 · 2020: 12 · 2019: 7 · 2018: 3 · 2017: 6 · 2016: 5 · 2015: 11 · 2014: 9 · 2013: 13 · 2012: 12
FWCI
18.05
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion)
  • ResearchSpace (University of Auckland) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
Keywords
endometriosis, danazol, pelvic pain, androgen therapy, endometrial atrophy, adjunctive surgery, androgenic side effects, women of reproductive age, placebo comparison, hormonal parameters, pain relief efficacy, drug safety and tolerability, cost-effectiveness, quality of life
MeSH terms
Danazol, Endometriosis, Estrogen Antagonists, Female, Humans, Randomized Controlled Trials as Topic, Pelvic Pain

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