It is given as a twice-daily nasal spray. Both drugs are similar in action but differ in length of effect as well as mode of delivery. Are there any side effects or complications? GnRH Analogs may cause temporary symptoms of the menopause in some women including hot flushes, headaches, nausea, mood changes, decrease in breast size, and vaginal dryness. During the first few days on the medication, some women will experience mild fluid retention, breast tenderness, and symptoms as though their period is about to start.
These symptoms are usually mild and generally are not significantly bothersome. There may be temporary burning, itching, swelling, discoloration of the skin, or soreness at the injection site with LUPRON although this is not common. All of the effects of GnRH Analogs on the ovaries are rapidly reversed when the medications are stopped. It is also more effective in managing endometriosis-related pain after surgery than using oral contraceptives in the same way [10].
The benefits may be particularly relevant for women with active peritoneal disease [1]. Use in recurrent endometriosis If you have recurrent disease, you may be able to have further courses of GnRH agonist treatment, but the dosage and length of time between courses needs to be carefully considered to minimise the likelihood of losing bone density in the long term [11].
Thinning of the bones may be less marked during a second course of treatment compared with the first [11]. In addition, add-back therapy may reduce the risk of bone thinning, and make repeated, intermittent or even continuous treatment possible for up to 2 years [1].
The GnRH agonists — like all the hormonal treatments for endometriosis — do not improve your chances of conceiving, without any reproductive techniques, so they should not be used as a treatment for infertility. You should see your gynaecologist about 6—8 weeks after beginning your course of a GnRH agonist to discuss how the treatment is progressing. GnRH agonists should not be used during pregnancy.
GnRH agonists are found in small amounts in breast milk, so they should not be used while breastfeeding. GnRH agonists may interact with other medicines. Let your doctor know about any medication you are taking, including non-prescribed drugs such as complimentary therapies or herbal medicine. Help us improve treatments for endometriosis and prevent this disease in the next generation of women.
Support the work of the World Endometriosis Research Foundation. This site is peer-reviewed for accuracy. They are modified versions of a naturally occurring hormone known as gonadotropin releasing hormone, which helps to control the menstrual cycle.
All the GnRH agonists are very similar chemically, but they come in different forms: three-monthly injection monthly injection daily injection nasal spray The names, forms and recommended dosages of the GnRH agonists used for endometriosis are shown in the table below. How they work All the GnRH agonists work in exactly the same way. The recommended dosage is two sprays into each nostril every 8 hours 3 times a day. Buserelin Suprefact injectable Daily injection Daily injections of buserelin start with a dosage of micrograms, and increase up to a maximum of micrograms.
The final dose is the minimum needed to alleviate pain symptoms. Goserelin Zoladex Monthly or three-monthly injection Goserelin is embedded in a small biodegradable implant about the size of a grain of rice. The implant is injected under the skin in the lower half of the abdomen once a month. Leuprorelin, Leuprolide Lupron Depot Monthly injection Leuprorelin comes as a monthly or, three-monthly, injection that is injected under the skin of the abdomen or arm, or sometimes into the buttock or thigh muscles.
Leuprorelin, Leuprolide Prostap SR Monthly injection Leuprorelin comes as a monthly or, three-monthly, injection that is injected under the skin of the abdomen or arm, or sometimes into the buttock or thigh muscles.
Leuprorelin, Leuprolide Enantone Monthly injection Leuprorelin comes as a monthly or, three-monthly, injection that is injected under the skin of the abdomen or arm, or sometimes into the buttock or thigh muscles. Leuprorelin, Leuprolide Lucrin Depot Monthly injection Leuprorelin comes as a monthly or, three-monthly, injection that is injected under the skin of the abdomen or arm, or sometimes into the buttock or thigh muscles.
Leuprorelin, Leuprolide Trenantone-Gyn Three-monthly injection Leuprorelin comes as a monthly or, three-monthly, injection that is injected under the skin of the abdomen or arm, or sometimes into the buttock or thigh muscles.
Naferelin Synarel Nasal Spray Nafarelin comes in a nasal spray pump. The recommended dosage is one spray of the pump into one nostril in the morning, and one spray into the other nostril in the evening every day. In a few women, the recommended dosage does not stop menstruation. If symptoms persist in these women, the dosage may be increased to one spray in both nostrils morning and night.
Naferelin Synarella Nasal Spray Nafarelin comes in a nasal spray pump. Triptorelin Decapeptyl SR Monthly and three-monthly injection Triptorelin comes as an injection that is injected under the skin or into the buttock muscle once a month or once every three months. Triptorelin Gonapeptyl Monthly injection Triptorelin comes as an injection that is injected under the skin or into the buttock muscle once a month or once every three months. If your gynaecologist does not prescribe add-back therapy, you might like to request it.
Side effects Menopausal-type symptoms The side effects of the GnRH agonists are largely the result of the low levels of oestrogen in the body, so they are usually confined to the symptoms associated with the menopause. The other common side effects are: insomnia decreased libido headaches mood swings vaginal dryness decreased breast size increased breast size acne muscle pains dizziness depression. The menopausal-type symptoms usually disappear soon after treatment ceases.
Effectiveness for pain symptoms All the GnRH agonists work in the same way, so they are equally effective in regressing endometrial implants and reducing pelvic pain symptoms [1]. This is known as add-back therapy and it has been shown to be effective in preventing the bone loss associated with extended use of GnRH agonists. It also may help reduce the severity of the hot flashes as well.
Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Ohlsson B. Front Endocrinol Lausanne.
Magon N. Gonadotropin releasing hormone agonists: Expanding vistas. Indian J Endocrinol Metab. Food and Drug Administration. Lupron Depot. Rossi L, Pagani O. J Womens Health Larchmt. Adverse effects of induced hot flashes on objectively recorded and subjectively reported sleep: results of a gonadotropin-releasing hormone agonist experimental protocol. Your Privacy Rights. To change or withdraw your consent choices for VerywellHealth.
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