Gonadotropin-Releasing Hormone Analogue (GnRH-A) Therapy
gonadotropin-releasing hormone analogue (GnRH-a)
To avoid long-term side effects, GnRH-a therapy is usually taken for only 3 to 6 months.
How It Works
Why It Is Used
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:
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 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 progesterone is recommended to prevent bone loss (osteoporosis). This is called "add-back" therapy.
Uterine fibroids. GnRH-a therapy is usually limited to presurgery treatment to:
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:1
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.
How Well It Works
Dysfunctional uterine bleeding. GnRH-a therapy causes a significant reduction in severe menstrual bleeding. This relieves anemia and reduces the need for blood transfusions. But blood loss returns to pretreatment levels when this treatment is stopped.
Uterine fibroids. Fibroids usually shrink to 35% to 65% of their original size.1
Ovarian cysts. GnRH-a therapy may reduce or prevent ovarian cysts that are related to ovulation.
Chronic pelvic pain. Women report improvement in pelvic pain at the end of treatment with:
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Call your doctor if you have:
Common side effects of this medicine include:
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Many doctors are prescribing GnRH-a therapy in combination with other medicines such as low-dose estrogen and progestin to control bone-thinning and decrease menopausal side effects, such as hot flashes. Add-back therapy is usually started if you need to be on GnRH-a therapy for more than 3 to 6 months.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
Do not use this medicine if you are pregnant, breast-feeding, or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
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