Oestrogen deficiency causes DNA damage in uterine leiomyoma cells: a possible mechanism for shrinkage of fibroids by GnRH agonists

Clinical use of GnRH analogues

“…Besides preventing direct oestrogen‐dependent stimulation of smooth muscle cell proliferation, additional molecular mechanisms by which GnRH analogues could affect myoma growth may be present, including direct inhibitory action on smooth muscle cells leading to DNA damage (Cheng et al ., 2001) and reduction of myoma blood supply. It was suggested that after GnRH analogue treatment a decreased expression of nitric oxide synthase, which is elevated in fibroids compared to parental myometrium, may cause vasoconstriction which would also explain the diminished blood loss during enucleation of fibroids after pretreatment with GnRH analogues (Gokdeniz et al ., 2000).…”