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- Title
Extending the treatment boundaries: Zoladex and add-back.
- Authors
Schlaff, W D
- Abstract
<bold>Objective: </bold>To review the evidence that add-back hormone replacement therapy (HRT) can ameliorate the metabolic consequences of gonadotropin-releasing hormone (GnRH) agonist treatment in women with symptomatic endometriosis.<bold>Methods: </bold>A review of relevant literature.<bold>Results: </bold>Early studies suggested that add-back HRT maintained bone mineral density (BMD) without reducing the symptomatic benefit of GnRH treatment. Both high-dose progestogen and low dose progestogen plus cyclical etidronate are effective in maintaining BMD. Standard and low dose HRT add-back may be more effective in relieving the hypo-estrogenic side-effects of GnRH agonist therapy. Randomized controlled studies have shown that both low-dose and standard-dose add-back HRT reduce the side-effects of GnRH agonist therapy, and that this benefit extends to 12 months of treatment.<bold>Conclusions: </bold>GnRH agonist treatment with add-back HRT seems to offer the hope of improved treatment for women with endometriosis, but the optimum treatment duration and time to start HRT have yet to be defined.
- Subjects
GOSERELIN; ENDOMETRIOSIS; HORMONES; LUTEINIZING hormone releasing hormone; THERAPEUTICS; BONE density
- Publication
International Journal of Gynecology & Obstetrics, 1999, Vol 64, pS25
- ISSN
0020-7292
- Publication type
journal article