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Endocrine effects of GnRH analogue with low‐dose hormone replacement therapy in women with endometriosis
Author(s) -
Howell R.,
Dowsett M.,
King N.,
Edmonds D. K.
Publication year - 1995
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1995.tb02926.x
Subject(s) - medicine , goserelin , endocrinology , medroxyprogesterone acetate , hormone replacement therapy (female to male) , hormone , buserelin , danazol , endometriosis , gonadotropin releasing hormone , luteinizing hormone , testosterone (patch) , cancer , agonist , breast cancer , receptor
Summary OBJECTIVE GnRH analogues are being used Increasingly for a number of oestrogen dependent conditions In women. The resultant profound hypo‐oestrogenism is a disadvantage, however, but the preservation of pituitary sensitivity to negative feedback by oestradiol is not well defined. We have determined the effect on gonadotrophins and Inhibin of GnRH analogue plus low‐dose continuous combined hormone replacement therapy In comparison with GnRH analogue therapy alone. DESIGN Randomized controlled trial. PATIENTS Fifty premenopausal women with endometriosis randomized to treatment with goserelin alone (Group 1) or goserelin plus 17βoestradiol and medroxyprogesterone acetate (Group 2). MEASUREMENTS FSH, LH, oestradiol, oestrone, Inhibin before and during treatment. RESULTS Oestradiol and oestrone were suppressed in both groups, but Group 2 had significantly higher oestradiol during the hormone replacement therapy period. LH was suppressed in both groups. In Group 1, FSH levels recovered during treatment but, in contrast, in Group 2, FSH levels remained suppressed throughout treatment. Inhibin was significantly lower in Group 2, but not In Group 1, during treatment compared to pretreatment. CONCLUSIONS Pituitary secretion of FSH appears to remain responsive to feedback control by oestradiol during GnRH analogue therapy and Is Incompletely suppressed, unlike LH which remains completely suppressed. The possible mechanisms for this are discussed.