How are GnRH analogues administered?

The GnRH analogues all require parenteral (subcutaneous or intramuscular) administration and are used largely as androgen deprivation therapy for advanced prostate cancer. They are used off-label for precocious puberty, gender dysphoria and infertility.

What is add-back therapy GnRH agonist?

Add-back hormone replacement therapy (HRT) can alleviate the undesirable hypo-oestrogenic effects of the gonadotrophin-releasing hormone (GnRH) agonists, including loss in bone mineral content.

What is an add-back therapy?

Add-back therapy allows the treatment of women with relapse of endometriosis-associated pain for a longer period, with reduced bone mineral density loss, good control of pain symptoms, and better patient quality of life compared with GnRH analogue alone or oral contraceptive.

Are GnRH analogues safe?

Gonadotropin releasing hormone analogues (GnRHa) have been used for treatment of central precocious puberty (CPP) for more than 15 years. They are generally considered safe although data on potential long-term side effects are scarce.

Where do you inject GnRH?

GnRH-a is given one of three ways:

• It can be injected into a muscle once a month. It is also available in a dose that lasts for 3 months.
• It can be injected under the skin of your belly once every 28 days.
• Or you can spray it into your nose twice a day.

Does GnRH cause weight gain?

Suppressing sex hormone levels in premenopausal women with gonadotropin-releasing hormone (GnRH) agonist therapy also causes fat gain. For example, women treated for 16 weeks with a GnRH agonist gained 1.0 kg of fat, which equates to an energy excess of about 80 kcal per day.

What does a GnRH analogue do when given to a woman?

GnRH agonists are a group of drugs that have been used to treat women with endometriosis for over 20 years [1]. They are modified versions of a naturally occurring hormone known as gonadotropin releasing hormone, which helps to control the menstrual cycle.

How does add back therapy work?

What is “Add–back” therapy? Add–back is a pill that contains a small amount of estrogen and progestin or progestin–only that is taken every day. Since hormones are important to keep your bones healthy, low levels of hormones can lower your bone density putting you at risk for osteoporosis (thinning of your bones).

How does add-back therapy work?

Is GHRH safe?

Conceptually, GHRH replacement would be the most physiological approach and its safety is guaranteed, provided an appropriate dose is used, in order to avoid hyperactivity of the GH/IGF-I axis. However, a long-acting preparation is needed.

How long does it take for GnRH to work?

You should notice an improvement in your symptoms within 4–8 weeks of beginning treatment, but some women will experience a temporary worsening of symptoms in the first 2 weeks.

Does GnRH cause weight loss?

Bone mineral density and uterine volume decreased significantly. Conclusion: Hypogonadism by GnRH agonist therapy induces lean mass loss, increased adiposity overall, and upper body fat accumulation.

Can a GnRH analogue be used in add back therapy?

There is concern, however, that add-back therapy may also limit the efficacy of the GnRH analogues and that it may not be able to completely prevent their adverse effects.

Are there any side effects to adding back to GnRH?

Add-back therapy can reduce the menopausal-type side effects of GnRH agonist therapy, which can make life more tolerable while on treatment. More importantly, it may have long-term benefits by preventing or minimising the thinning of the bones associated with treatment with a GnRH agonist alone.

Can you take GnRH analogues for hot flushes?

Uterine fibroids may be shrunk with gonadotropin-releasing hormone (GnRH) analogues but commonly cause hot flushes. Combining GnRHa with other drugs may decrease hot flushes (a strategy known as add-back therapy) but cause other problems such as low bone mineral density. The efficacy and safety of this approach is controversial.

How are GnRH analogues used to treat uterine fibroids?

Combined treatment with GnRH analogues and add-back therapy for women with uterine fibroids. Medical options for treating the condition are limited and, among them, a class of drugs named GnRH analogues is considered effective for decreasing the size of the tumour and for controlling symptoms such as uterine bleeding and pelvic pressure.