Gonadotropin-releasing hormone agonists
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How these medicines are taken
GnRH-a therapy is limited to a short period of time (3 to 6 months). For some women, the benefits of treatment are only a temporary solution, lasting several months. For others, relief is long-lasting.
Gonadotropin-releasing hormone agonist (GnRH-a) therapy is widely used to shrink endometriosis implants, which relieves pain. GnRH-a therapy is usually a second-choice treatment that is used when several months of birth control pill therapy have not been effective.
GnRH-a therapy is sometimes used before surgery to make implants easier to remove. This can help reduce the amount of scar tissue created by the surgery.
Like all hormone therapies and surgery for endometriosis, GnRH-a therapy does not cure the disease.
Up to 90% of women report full or partial pain relief after 6 months of GnRH-a therapy. Treatment also shrinks endometriosis implants in about 90% of women.2
GnRH-a therapy after surgery can extend pain relief by preventing the growth of new or returning endometriosis.3
After GnRH-a treatment, or any other hormone therapy, endometriosis pain can return.2
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 911 or other emergency services right away if you have:
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.)
These medicines are given as a shot or a nasal spray. You will get instructions on how to give the shot or use the nasal spray. Ask your doctor or pharmacist if you have any questions about how to take your medicine correctly.
Add-back therapy. 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 the side effects of menopause, such as hot flashes.
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.
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.
- American Society for Reproductive Medicine (2012). Endometriosis and infertility: A committee opinion. Fertility and Sterility, 98(3): 591–598.
- Fritz MA, Speroff L (2011). Endometriosis. In Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 1221–1248. Philadelphia: Lippincott Williams and Wilkins.
- American College of Obstetricians and Gynecologists (2010). Management of Endometriosis. ACOG Practice Bulletin No. 114. Obstetrics and Gynecology, 116(1): 225–236.
Last Revised: May 14, 2012
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