The GnRH agonists in the treatment of uterine leiomyomas

The observation that fibroids regress after the menopause has led many authors to use GnRH agonists to obtain a reversible state of hypoestrogenism in patients with this tumor. In all the studies performed GnRH agonists have been found effective in inducing a marked regression of fibroids and resolution of the related symptoms. The only serious side effect reported has been a decrease of bone mineral density, which necessarily limits the duration of treatment. Fibroids have been observed to grow back in almost all patients a few months after suspension of treatment, and this limits the indications for the use of GnRH agonist in the treatment of this condition. GnRH agonists are the treatment of choice, however, in inoperable patients and in those with severe anemia, whereas further studies are needed to better define their use in preoperative treatment and in women in perimenopausal age.