Two-step gonadotropin-releasing hormone agonist treatment of uterine leiomyomas: standard-dose therapy followed by reduced-dose therapy

American Journal of Obstetrics and Gynecology
F J BroekmansJ Schoemaker

Abstract

Gonadotropin-releasing hormone agonist-induced partial pituitary suppression with low-grade estrogen production may be useful in long-term treatment of uterine leiomyomas. Twenty-seven women with uterine leiomyomas were treated with a standard dose of triptorelin for 8 weeks. Patients were then randomized to use 100, 20, or 5 micrograms of triptorelin until week 26. Uterine and myoma size, pituitary-ovarian function, bone metabolism, and bone mineral density were monitored. During standard treatment uterine size was reduced to 67.1% of baseline. During randomized treatment uterine size was further reduced to 57.8% of baseline. There were no differences in overall volume reduction among the groups. Luteinizing hormone and estradiol levels were restored in a dose-dependent way. Bone mineral density decreased significantly in the highest-dose group at week 26. This study shows that the beneficial effects of initial high-dose agonist treatment on uterine leiomyomas can be preserved by continued low-dose treatment. Bone mineral density does not seem to change during reduced-dose agonist treatment.

References

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Citations

Jul 4, 2009·Taiwanese Journal of Obstetrics & Gynecology·Peng-Hui WangHsiang-Tai Chao
Aug 16, 2015·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Sara M Drayer, William H Catherino
Mar 7, 2008·Expert Opinion on Emerging Drugs·Ming-Huei Cheng, Peng-Hui Wang
May 14, 2010·Systems Biology in Reproductive Medicine·Yong JiangJean Y J Wang
Oct 30, 2004·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·T FuruiS Shiraki
Feb 24, 2001·Lancet·E A Stewart
Oct 3, 1999·Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN·M E Rousseau
Sep 10, 2003·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·A ImaiT Tamaya
Oct 2, 2007·Best Practice & Research. Clinical Obstetrics & Gynaecology·Anne E Lethaby, Beverley J Vollenhoven
Jun 28, 2017·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Dana DvorskáJozef Višňovský
Feb 9, 2013·The Journal of Clinical Endocrinology and Metabolism·Md Soriful IslamPasquapina Ciarmela

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