Luteinizing hormone-releasing hormone receptor antagonist may reduce postmenopausal flushing

Hormone therapy (HT) is the most effective treatment of postmenopausal (PMP) flushing; however, its use is often contraindicated. As an alternative option, we explored the efficacy of the luteinizing hormone-releasing hormone (LHRH) receptor antagonist cetrorelix in women with severe PMP flushing.

We conducted an open-label treatment with cetrorelix 250 μg twice a day on 10 women with a baseline daily flush score of 15 or higher for a period of 4 to 6 weeks. The response to treatment was evaluated through monitoring serum gonadotropin levels, flush scores, and quality of life.

At baseline, the mean (SEM) daily flush score was 36.1 ± 1.8 (mean ± SEM range, 29-44). All women demonstrated a decrease in serum luteinizing hormone and follicle-stimulating hormone during treatment, but the premenopausal levels of both gonadotropins were reached in only two women. The mean daily flush score decreased by 42.0% ± 7.7% (P < 0.001). This was caused by a decrease in flush frequency of 26.2% ± 6.0% (P < 0.01) and by a decrease in flush severity of 21.2% ± 7.7% (P < 0.05).

In an open-label setting, luteinizing hormone-releasing hormone receptor blockade reduced PMP flushing by at least 25% in 8 of 10 women with severe flushing. A placebo-controlled study will be needed to demonstrate the true benefit of this approach. The present data suggest that the treatment period must be longer than 6 weeks to capture the maximal effect.