For Medical Management of Uterine Fibroids, Consider Both Sides of the GnRH Coin

In a Japanese trial, the GnRH antagonist relugolix was noninferior to the agonist leuprolide and induced amenorrhea faster.

Medical management of uterine fibroids involves suppressing ovarian estradiol and progesterone production, thereby reducing fibroid size and resolving heavy uterine bleeding. Gonadotropin-releasing hormone (GnRH) agonists such as leuprolide (also known as leuprorelin) initially stimulate ovarian activity but, with continued treatment, suppress this activity; therefore, up to 6 weeks are required to achieve a reduction in ovarian steroidogenesis. In contrast, GnRH antagonists rapidly suppress ovarian activity; moreover, they can be taken orally whereas GnRH agonists must be administered by injection. To evaluate the efficacy of an oral GnRH antagonist (relugolix) versus a parenteral GnRH agonist (leuprolide), researchers in Japan conducted a…

Reviewing Author

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

For Medical Management of Uterine Fibroids, Consider Both Sides of the GnRH Coin

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Reviewing Author