Roles of Goserelin in Gynecological Disorders

Goserelin is a gonadotropin-releasing hormone (GnRH) agonist with a long history of clinical application and well-established efficacy and safety profile. Its mechanism of action centers on sustained GnRH receptor desensitization, leading to pituitary downregulation, ovarian suppression, and reduction of estradiol and progesterone to postmenopausal levels; this forms the basis for its efficacy in hormone-dependent gynecological conditions. Over the past three decades, the use of goserelin has been expanded to an increasing number of indications and clinical scenarios. Approved gynecological indications of goserelin include endometriosis, uterine fibroids, usage as an agent for endometrial thinning, and usage as an agent for ovarian downregulation prior to assisted reproduction. More recent research continues to explore the use of goserelin in gynecological diseases such as adenomyosis and different types of female cancers. Goserelin may also be a useful tool in clinical scenarios where gynecologic management is required as part of multi-disciplinary therapy. This review consolidates the established and emerging roles of goserelin across the broad spectrum of benign and malignant gynecological conditions, underscoring its remarkable clinical versatility and the breadth of evidence that support its continued expansion of utility in contemporary practice.