Add-Back and Combined Regulation in GnRH-a Treatment of Endometriosis

Objective: The purpose of this review is to summarize drug selection for peri-menopausal symptoms caused by gonadotropin releasing-hormone agonist (GnRH-a) in the treatment of endometriosis. Mechanism: GnRH-a treatment often leads to low estrogen levels, resulting in peri-menopausal symptoms and ost...

Full description

Saved in:
Bibliographic Details
Main Authors: Huimin Tang, Qiucheng Jia, Zhiyong Dong, Yao Chen, Wulin Shan, Yihan Wu, Miao Miao, Tingwei Xing, Weiwei Wei, Bin Tang, Hong Zheng, Ruxia Shi, Bairong Xia, Jiming Chen
Format: Article
Language:English
Published: IMR Press 2023-10-01
Series:Clinical and Experimental Obstetrics & Gynecology
Subjects:
Online Access:https://www.imrpress.com/journal/CEOG/50/10/10.31083/j.ceog5010224
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849402499664969728
author Huimin Tang
Qiucheng Jia
Zhiyong Dong
Yao Chen
Wulin Shan
Yihan Wu
Miao Miao
Tingwei Xing
Weiwei Wei
Bin Tang
Hong Zheng
Ruxia Shi
Bairong Xia
Jiming Chen
author_facet Huimin Tang
Qiucheng Jia
Zhiyong Dong
Yao Chen
Wulin Shan
Yihan Wu
Miao Miao
Tingwei Xing
Weiwei Wei
Bin Tang
Hong Zheng
Ruxia Shi
Bairong Xia
Jiming Chen
author_sort Huimin Tang
collection DOAJ
description Objective: The purpose of this review is to summarize drug selection for peri-menopausal symptoms caused by gonadotropin releasing-hormone agonist (GnRH-a) in the treatment of endometriosis. Mechanism: GnRH-a treatment often leads to low estrogen levels, resulting in peri-menopausal symptoms and osteoporosis. Add-back therapy relieves clinical symptoms by supplementing low-dose estrogen. The idea of “combined regulation” is to improve symptoms by adding plant preparations or proprietary Chinese medicines. Studies have shown that they may play a role by regulating serotonin activity. Findings in Brief: For patients treated with GnRH-a for less than 3 months, the combined-regulation regimen can be considered, whereas for patients who have had more than 3 courses of GnRH-a, add-back therapy with sex hormones must be used because the patients will have begun to have obvious bone-mass loss and even bone pain; this bone-mass loss is often irreversible. Conclusions: In the early treatment of endometriosis with GnRH-a, non-hormone combined-regulation therapy is a relatively safe and feasible choice, but hormone add-back therapy should be selected for patients who have had more than 3 courses of GnRH-a.
format Article
id doaj-art-9bda9efe1ae042c39793d7c785ff1ea2
institution Kabale University
issn 0390-6663
language English
publishDate 2023-10-01
publisher IMR Press
record_format Article
series Clinical and Experimental Obstetrics & Gynecology
spelling doaj-art-9bda9efe1ae042c39793d7c785ff1ea22025-08-20T03:37:31ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-10-01501022410.31083/j.ceog5010224S0390-6663(23)02149-8Add-Back and Combined Regulation in GnRH-a Treatment of EndometriosisHuimin Tang0Qiucheng Jia1Zhiyong Dong2Yao Chen3Wulin Shan4Yihan Wu5Miao Miao6Tingwei Xing7Weiwei Wei8Bin Tang9Hong Zheng10Ruxia Shi11Bairong Xia12Jiming Chen13Department of Gynecology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Obstetrics and Gynecology, Second Affiliated Hospital of Chongqing Medical University, 400010 Chongqing, ChinaDepartment of Gynecology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 230031 Hefei, Anhui, ChinaDepartment of Gynecology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 230031 Hefei, Anhui, ChinaDepartment of Gynecology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaDepartment of Gynecology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 230031 Hefei, Anhui, ChinaDepartment of Gynecology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 213000 Changzhou, Jiangsu, ChinaObjective: The purpose of this review is to summarize drug selection for peri-menopausal symptoms caused by gonadotropin releasing-hormone agonist (GnRH-a) in the treatment of endometriosis. Mechanism: GnRH-a treatment often leads to low estrogen levels, resulting in peri-menopausal symptoms and osteoporosis. Add-back therapy relieves clinical symptoms by supplementing low-dose estrogen. The idea of “combined regulation” is to improve symptoms by adding plant preparations or proprietary Chinese medicines. Studies have shown that they may play a role by regulating serotonin activity. Findings in Brief: For patients treated with GnRH-a for less than 3 months, the combined-regulation regimen can be considered, whereas for patients who have had more than 3 courses of GnRH-a, add-back therapy with sex hormones must be used because the patients will have begun to have obvious bone-mass loss and even bone pain; this bone-mass loss is often irreversible. Conclusions: In the early treatment of endometriosis with GnRH-a, non-hormone combined-regulation therapy is a relatively safe and feasible choice, but hormone add-back therapy should be selected for patients who have had more than 3 courses of GnRH-a.https://www.imrpress.com/journal/CEOG/50/10/10.31083/j.ceog5010224add-back therapycombined regulationendometriosisgnrh-asex hormone
spellingShingle Huimin Tang
Qiucheng Jia
Zhiyong Dong
Yao Chen
Wulin Shan
Yihan Wu
Miao Miao
Tingwei Xing
Weiwei Wei
Bin Tang
Hong Zheng
Ruxia Shi
Bairong Xia
Jiming Chen
Add-Back and Combined Regulation in GnRH-a Treatment of Endometriosis
Clinical and Experimental Obstetrics & Gynecology
add-back therapy
combined regulation
endometriosis
gnrh-a
sex hormone
title Add-Back and Combined Regulation in GnRH-a Treatment of Endometriosis
title_full Add-Back and Combined Regulation in GnRH-a Treatment of Endometriosis
title_fullStr Add-Back and Combined Regulation in GnRH-a Treatment of Endometriosis
title_full_unstemmed Add-Back and Combined Regulation in GnRH-a Treatment of Endometriosis
title_short Add-Back and Combined Regulation in GnRH-a Treatment of Endometriosis
title_sort add back and combined regulation in gnrh a treatment of endometriosis
topic add-back therapy
combined regulation
endometriosis
gnrh-a
sex hormone
url https://www.imrpress.com/journal/CEOG/50/10/10.31083/j.ceog5010224
work_keys_str_mv AT huimintang addbackandcombinedregulationingnrhatreatmentofendometriosis
AT qiuchengjia addbackandcombinedregulationingnrhatreatmentofendometriosis
AT zhiyongdong addbackandcombinedregulationingnrhatreatmentofendometriosis
AT yaochen addbackandcombinedregulationingnrhatreatmentofendometriosis
AT wulinshan addbackandcombinedregulationingnrhatreatmentofendometriosis
AT yihanwu addbackandcombinedregulationingnrhatreatmentofendometriosis
AT miaomiao addbackandcombinedregulationingnrhatreatmentofendometriosis
AT tingweixing addbackandcombinedregulationingnrhatreatmentofendometriosis
AT weiweiwei addbackandcombinedregulationingnrhatreatmentofendometriosis
AT bintang addbackandcombinedregulationingnrhatreatmentofendometriosis
AT hongzheng addbackandcombinedregulationingnrhatreatmentofendometriosis
AT ruxiashi addbackandcombinedregulationingnrhatreatmentofendometriosis
AT bairongxia addbackandcombinedregulationingnrhatreatmentofendometriosis
AT jimingchen addbackandcombinedregulationingnrhatreatmentofendometriosis