Long-acting gonadotropin hormone-releasing hormone analog used to treat uteri

C. C. Coddington, R. L. Collins, T. H. Shawker, R. Anderson, D. L. Loriaux, C. A. Winkel

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81 Scopus citations

Abstract

Because the size of leiomyomata uteri often decreases significantly after menopause, the authors elected to employ a long-acting gonadotropin hormone-releasing hormone analog (GnRH-a) (imbzl-D-His6-Pro9-Net-GnRH) to create a state of pseudomenopause in six patients with leiomyomata uteri diagnosed on the basis of pelvic examination and confirmed by pelvic ultrasonography. Patients received daily, subcutaneous injections of GnRH-a (4 μg x kg-1 x 24 hour-1) for 6 months. Uterine size (13.8 ± 4 weeks [mean ± standard deviation (SD), n = 6] was determined by pelvic examination and uterine volume (533.9 ± 394 ml [mean ± SD, n = 6]) was determined by pelvic ultrasonography before medical therapy was begun. They observed a decrease in uterine size by pelvic examination within 4 weeks of the initiation of therapy, and all patients experienced a decrease in uterine size (9.5 ± 4 weeks [mean ± SD, n = 6]) (P<0.05) within 8 weeks of initiation of therapy. After 6 months of therapy, uterine size was 229.5 ± 145 ml (mean ± SD, n = 6). During treatment, plasma estrogen concentrations were assessed intermittently (every 1 to 4 weeks) and remained <4 pg x ml-1 throughout the period of therapy. All six patients have discontinued therapy. There has been no increase in uterine size in these patients for a period from 3 to 7 months. The authors conclude that administration of a long-acting GnRH-a appears to be a practical method for reducing the size of uterine leiomyomata and may serve a useful role either as a primary means of therapy or as an adjunct to surgical myomectomy, especially in patients with exceedingly large myomas who wish to conserve reproductive capability.

Original languageEnglish (US)
Pages (from-to)624-629
Number of pages6
JournalFertility and sterility
Volume45
Issue number5
DOIs
StatePublished - Jan 1 1986

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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    Coddington, C. C., Collins, R. L., Shawker, T. H., Anderson, R., Loriaux, D. L., & Winkel, C. A. (1986). Long-acting gonadotropin hormone-releasing hormone analog used to treat uteri. Fertility and sterility, 45(5), 624-629. https://doi.org/10.1016/S0015-0282(16)49332-5