Gonadotropin-Releasing Hormone Analogue (GnRH-A) Therapy

GnRH-a therapy is used to help diagnose or treat disorders that are linked to menstrual hormones, such as endometriosis and uterine fibroids. GnRH-a therapy may be used:

• For dysfunctional uterine bleeding or Reference ovarian cysts Opens New Window.
• For endometriosis.
• When an Reference ultrasound Opens New Window has confirmed that uterine fibroids are present and they cause significant symptoms.

Dysfunctional uterine bleeding. GnRH-a therapy is used under special circumstances, such as when no other medical treatment has reduced uterine bleeding and a woman wants to avoid surgery.

GnRH-a therapy is sometimes used to thin the Reference endometrium Opens New Window before Reference endometrial ablation Opens New Window for dysfunctional uterine bleeding.

GnRH-a is a good choice for women who have heavy menstrual periods after organ transplant procedures, especially a liver transplant. If it is used for long-term therapy after organ transplant, then additional treatment with daily estrogen and Reference progesterone Opens New Window is recommended to prevent bone loss (Reference osteoporosis Opens New Window). This is called "add-back" therapy.

Uterine fibroids. GnRH-a therapy is usually limited to presurgery treatment to:

• Shrink fibroids before removal by Reference myomectomy Opens New Window or Reference hysterectomy Opens New Window.
• Correct Reference anemia Opens New Window caused by heavy bleeding. (Iron supplements are another option for correcting anemia.)

GnRH-a therapy is not usually used to relieve fibroid symptoms only, because fibroids grow back fairly quickly after GnRH-a therapy ends. But for women who are close to menopause (when fibroids shrink), short-term relief with GnRH-a therapy may be a reasonable option.

Before gynecologic surgery. GnRH-a therapy may be used before surgery to:^{Reference 1}

• Reduce the size of fibroids or endometriosis sites (implants), allowing for easier removal of the problem growths or the uterus (hysterectomy).
• Attempt to prevent scarring that might occur after surgery.

GnRH-a therapy is usually used for short periods of time (3 to 6 months). It can weaken the bones when used for longer periods of time.

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