Journal
JOURNAL OF PEDIATRIC AND ADOLESCENT GYNECOLOGY
Volume 30, Issue 3, Pages 422-424Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jpag.2016.12.002
Keywords
Endometriosis; Gynecology; Progesterone; Norethindrone; Hepatic adenoma; Abdominal pain
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Background: Endometriosisdectopic implantation of endometrial-like tissuedaffects 10% of female adolescents and adults. First-line treatment includes progesterone only (such as norethindrone acetate [NET-A]) or combined estrogen/progestin oral contraceptive pills. Estrogen-containing contraceptives confer increased risk of hepatic adenomas, whereas the association with NET-A is very rarely reported. Case: Three adolescents with stage I to II endometriosis managed with NET-A (up to 15 mg/d for 28-78 months) were diagnosed with hepatic adenomas at ages 17-22 years. They previously received estrogen-containing medications, which were stopped 24 months or longer before diagnosis of hepatic adenoma. Summary and Conclusion: NET-A in a dose greater than 10 mg/d might be associated with increased risk for hepatic adenomas, likely due to peripheral conversion to ethinyl estradiol. Use of NET-A might not be advisable in patients with known hepatic adenomas.
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