Treatment of uterine fibroids with GnRH-analogues prior to hysterectomy

Abstract

GnRH-analogues have a longer half-life and stronger receptor affinity than native GnRH. They block the secretion of gonadotropins from the anterior pituitary, producing a hypoestrogenic state. Preoperative treatment with GnRH-agonists for 3 months prior to hysterectomy reduces the size of uterine fibroids by about 50%. The hematologic profile is improved and subjective symptoms reduced. Other results are: a smaller peroperative blood loss, a shorter hospitalization time, and a tendency to easier operations. Side effects are predominantly hypoestrogenic. Treatment with GnRH-agonists before hysterectomy is recommended in cases of large fibroids, when technical problems may be anticipated, when preoperative anemia is present, or when it is desirable to postpone surgery.