Hepatic Adenomas in Adolescents with Endometriosis Treated with Norethindrone Acetate

Endometriosis—the implantation of endometrial-like tissue outside of the uterus— affects approximately 10% of female adolescents and adults, who often experience pain and infertility. First-line medical treatment includes treatment with progesterone-only or combined oral contraceptive pills. Estrogen-containing contraceptives are associated with increased risk of hepatic adenomas (3-4 per 100,000), which can cause life-threatening hemorrhage1. Association of progesterone-only medications with hepatic adenomas has not been reported, though peripheral conversion of norethindrone acetate (NET-A) to ethinyl estradiol—at serum levels comparable to levels in patients ingesting ethinyl estradiol primarily—has been reported2,3.

Source: Journal of Pediatric and Adolescent Gynecology - February 19, 2016 Category: OBGYN Authors: P.C. Brady, S.A. Missmer, M.R. Laufer Source Type: research