[Bone loss induced by GnRHa treatment in women]

The hypoestrogenic state induced by gonadotropin-releasing hormone agonist(GnRHa) has been shown to be effective in the treatment of uterine leiomyoma and endometriosis but to induce bone loss. The BMD significantly decreased from baseline(-4.9 +/- 2.5%, mean +/- SD) after 24 weeks of treatment of leuprolide acetate depot(p < 0.01), and remained significantly below the baseline(-3.4 +/- 2.7%, p < 0.01) at 12 months after the treatment period. To minimize bone loss without compromising efficacy, several investigators have sought to 'add-back' sex-steroid hormones or other bone-sparing agents. Unresolved issues from these studies include ideal regimens and whether the add-back therapy prevents bone loss without compromising efficacy. GnRHa plus oral bisphosphonate therapy prevents bone loss without deteriorating the therapeutic effect of GnRHa.