Luteinizing Hormone-releasing Hormone Agonist and Uterine Leiomyoma

Postoperative GnRH Analog Treatment for the Prevention of Recurrences of Uterine Myomas after Myomectomy

“…These drugs have been shown to be effective in reducing the myoma volume. Maheux et al [12] reported a mean decrease of 71 %, Healy et al [ 13] a decrease of 61 %. In all studies in which analogs were used, patient response was extremely variable, generally occurring within the first 3 months of treatment; more recent publications, however, reported regrowth of the uterus up to or even beyond the pretreat ment volume in most women [13,16].…”

“…Over the last few years, several studies have been pub lished on the beneficial effects of GnRHA administration in patients with leiomyomata uteri [12][13][14][15]. These drugs have been shown to be effective in reducing the myoma volume.…”

The Short-Term Use of Luteinising Hormone-Releasing Hormone Analogues in Uterine Fibroids

“…Estimations of the fre quency of symptoms secondary to fibroids vary and 20-50% of fibroids have been reported in different series to produce symptoms. These symptoms may include men strual disturbances, pelvic pain, infertility and pregnancy complications [1], Since fibroids arise during the reproductive years, may enlarge with pregnancy and tend to regress in the post menopausal period, E2 has been implicated as a possible factor in the development of these tumours, probably with one or more of the growth factors acting synergistically [2,3], The development of the LHRH agonist and antagonist analogues over the past 10 -15 years has given the clinician a reversible means of rendering patients hypogonadal -either by pituitary desensitisation with agon ists or by direct inhibition with antagonists [4], The LHRH agonist analogues have proved remarkably free of side effects when used as short-term therapy and their ability to produce profound hypo-oestrogenism has given them a possible role in the management of a wide range of oestrogen-dependent gynaecological disorders [5], The 'pseudo-menopause' or medical castration which follows continuous administration was initially investigated as a possible alternative form of contraception [6,7] and the LHRH agonists have subsequently been used in the man agement of endometriosis and the premenstrual syn drome with considerable success [8][9][10] Treatment with short-acting LHRH agonist analogues has resulted in the shrinkage of fibroids, secondary to the induction of hypooestrogenism [11][12][13]. Unfortunately, cessation of ther apy and the restoration of normal ovarian steroidogene sis results in the regrowth of the fibroids and so the benefits are of short duration [14].…”

Treatment of Uterine Leiomyomata: Past, Present and Future

“…Short-term treatment up to 6 months does not seem to exert deleterious effects. HDL-cholesterol does not change or is slightly, but insignificantly, increased during LHRH-A treatment [47,54], This beneficial effect may be explained by an alteration of the androgen/oestrogen ratio or by the fact that when low dosage of LHRH-A is used [47,54], some oestrogen stimulation is preserved, whilst progesterone production is blocked. No other sig nificant effect has been reported.…”

“…In terms of side effects, however, the preservation of some oestrogen stimulation makes a big difference, less hot flushes [47), bone preservation [54] and increased HDL [47][48][49][50][51][52][53][54], Therefore, it seems possible to control uterine leiomyomas, while preserving some oestrogen.…”