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GnRH analogues in the treatment of fibroids

Published online by Cambridge University Press:  02 March 2009

Christine P West
Christine P West*
Affiliation:
University of Edinburgh, UK
*
Christine P West, Department of Obstetrics and Gynaecology, University of Edinburgh, Centre for Reproductive Biology, 37 Chalmers Street, Edinburgh EH3 9EW, UK.
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Extract

Uterine fibroids are estimated to affect up to 25% of women of reproductive age and are a common cause of morbidity, being associated with menstrual dysfunction, iron deficiency anaemia, pregnancy wastage and subfertility. Their pathogenesis remains unknown but their association with ovarian function and oestrogen production is undisputed and supported by their occurrence only after puberty and the shrinkage observed after the menopause. This oestrogen dependency has recently been exploited therapeutically through investigation of the use of agents that induce a hypo-oestrogenic state, the gonadotrophin-releasing hormone (GnRH) or luteinizing hormone-releasing hormone (LHRH) analogues.

Type
Articles
Information
Reproductive Medicine Review , Volume 2 , Issue 3 , October 1993 , pp. 181 - 197
Copyright
Copyright © Cambridge University Press 1993

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References

1Smith, CJ. Hysterectomy for benign pelvic conditions. Am J Obstet Gynecol 1952; 64: 1211–20.CrossRefGoogle ScholarPubMed
2Buttram, VC, Reiter, RC. Uterine leiomyomata: etiology, symptomatology and management. Fertil Steril 1981; 36: 433–45.Google ScholarPubMed
3West, CP. Uterine fibroids. In: Shaw, RW, Soutter, WP, Stanton, SL eds. Gynaecology. Edinburgh: Churchill Livingstone, 1992: 397–411.Google Scholar
4Gordon, K, Hodgen, GD. Will GnRH antagonists be worth the wait? Reprod Med Rev 1992; 1: 189–94.CrossRefGoogle Scholar
5Sandow, J. Clinical application of LHRH and its analogues. Clin Endocrinol 1983; 18: 571–92.CrossRefGoogle ScholarPubMed
6Fraser, MH, Baird, DT. Clinical applications of LHRH analogues. Clin Endocrinol Metab 1987; 1: 43–70.Google ScholarPubMed
7West, CP. LHRH analogues in the management of uterine fibroids, premenstrual syndrome and breast malignancies. Baillieres Clin Obstet Gynaecol 1988; 2: 689–709.CrossRefGoogle ScholarPubMed
8West, CP, Baird, DT. Suppression of ovarian activity by Zoladex depot (ICI 118630), a long-acting luteinizing hormone releasing hormone agonist analogue. Clin Endocrinol 1987; 26: 213–20.CrossRefGoogle ScholarPubMed
9West, CP, Lumsden, MA, Lawson, S, Williamson, J, Baird, DT. Shrinkage of uterine fibroids during therapy with goserelin (Zoladex): a luteinizing hormone-releasing hormone agonist administered as a monthly subcutaneous depot. Fertil Steril 1987; 48: 45–51.CrossRefGoogle ScholarPubMed
10Matta, WHM, Shaw, RW, Nye, M. Long term follow-up of patients with uterine fibroids after treatment with the LHRH agonist buserelin. Br J Obstet Gynecol 1989; 96: 200–206.CrossRefGoogle ScholarPubMed
11Filicori, M, Hall, DA, Loughlin, JS, Rivier, J, Vale, W, Crowley, WF. A conservative approach to the management of uterine leiomyomata: pituitary desensitisation by a luteinizing hormone-releasing hormone analogue. Am J Obstet Gynecol 1983; 147: 726–27.CrossRefGoogle Scholar
12Maheux, R, Guilloteau, C, Lemay, A, Bastide, A, Fazekas, AT. Luteinizing hormone-releasing hormone agonist and uterine leiomyoma: a pilot study. Am J Obstet Gynecol 1985; 152: 1034–38.CrossRefGoogle ScholarPubMed
13Healy, DL, Lawson, SR, Abbott, M, Baird, DT, Fraser, HM. Towards removing uterine fibroids without surgery: subcutaneous infusion of a luteinizing hormone-releasing hormone agonist commencing in the luteal phase. J Clin Endocrinol Metab 1986; 63: 619–25.CrossRefGoogle Scholar
14Maheux, R, Lemay, A, Merat, P. Use of intranasal luteinizing hormone-releasing hormone agonist in uterine leiomyomas. Fertil Steril 1987; 7: 229–33.CrossRefGoogle Scholar
15Friedman, AJ, Barbieri, RL, Benacerraf, BR, Schiff, I. Treatment of leiomyomata with intranasal or subcutaneous leuprolide, a gonadotropin-releasing hormone agonist. Fertil Steril 1987; 48: 560–64.CrossRefGoogle ScholarPubMed
16Perl, V, Marquez, J, Schally, AV et al. Treatment of leiomyomata uteri with D-Trp-6-luteinizing hormone-releasing hormone. Fertil Steril 1987; 48: 383–89.CrossRefGoogle Scholar
17Kessel, B, Liu, J, Berga, S, Yen, SSC. Treatment of uterine fibroids with agonist analogues of gonadotropin-releasing hormone. Fertil Steril 1988; 49: 538–41.CrossRefGoogle ScholarPubMed
18Andreyko, JL, Blumenfeld, Z, Marshall, A, Monroe, SE, Hricak, H, Jaffe, RB. Use of an agonist analog of gonadotropin-releasing hormone (nafarelin) to treat leiomyomas: Assessment of magnetic resonance imaging. Am J Obstet Gynecol 1988; 158: 903–10.CrossRefGoogle ScholarPubMed
19Golan, A, Bukovsky, I, Schneider, D, Ron-El, R, Herman, A, Caspi, E. D-Trp-6 luteinizing hormone-releasing hormone microcapsules in the treatment of uterine leiomyomas. Fertil Steril 1989; 52: 406–11.CrossRefGoogle ScholarPubMed
20Lettrie, GS, Coddington, CG, Winkel, CA, Shawker, TH, Loriaux, DL, Collins, RL. Efficacy of a gonadotropin-releasing hormone agonist in the treatment of uterine leiomyomata: long-term follow-up. Fertil Steril 1989; 51: 951–56.CrossRefGoogle Scholar
21Schlaff, WD, Zernouni, EA, Huth, J, Chan, J, Damewood, MD, Rock, JA. A placebo-controlled trial of a depot gonadotropin-releasing hormone analog (leuprolide) in the treatment of uterine leiomyomata. Obstet Gynecol 1989; 74: 856–62.Google ScholarPubMed
22Friedman, AJ, Hoffman, DI, Comite, F, Browneller, RW, Miller, JD. Treatment of leiomyomata uteri with leuprolide acetate depot: a double-blind, placebo-controlled, multicenter study. The leuprolide study group. Obstet Gynecol 1991; 77: 720–25.Google ScholarPubMed
23Vollenhoven, BJ, Shekleton, P, McDonald, J, Healy, DL. Clinical predictors of buserelin acetate treatment of uterine fibroids: a prospective study of 40 women. Fertil Steril 1990; 54: 1032–38.CrossRefGoogle ScholarPubMed
24Costanini, S, Anserini, P, Valenzana, M, Remorgida, V, Venturi, PL, De Cecco, L. Luteinizing hormone-releasing hormone analogue therapy of uterine fibroids: analysis of results obtained with buserelin administered intranasally and goserelin administered subcutaneously as a monthly depot. Eur J Obstet Gynecol Reprod Biol 1990; 37: 63–69.CrossRefGoogle Scholar
25Watanabe, Y, Nakamura, G, Matsuguchi, H, Nozaki, M, Sano, M, Nakano, H. Efficacy of a low-dose leuprolide acetate depot in the treatment of uterine leiomyomata in Japanese women. Fertil Steril 1992; 58: 66–71.CrossRefGoogle ScholarPubMed
26West, CP, Lumsden, MA. Fibroids and menorrhagia. Baillieres Clin Obstet Gynaecol 1989; 3: 357–74.CrossRefGoogle ScholarPubMed
27Zawin, M, McCarthy, S, Scoutt, L, Lange, R, Lavy, G, Vulte, J, Comite, F. Monitoring therapy with a gonadotropin-releasing hormone analogue: utility of MR imaging. Radiology 1990; 175: 503–506.CrossRefGoogle ScholarPubMed
28Williams, IA, Shaw, RW. Effects of nafarelin on uterine fibroids measured by ultrasound and magnetic resonance imaging. Eur J Obstet Gynecol Reprod Biol 1990; 34: 111–17.CrossRefGoogle ScholarPubMed
29Friedman, AJ, Daly, M, Juneau-Norcross, M, Rein, MS. Predictors of uterine volume reduction in women with myomas treated with a gonadotropin-releasing hormone agonist. Fertil Steril 1991; 58: 413–15.CrossRefGoogle Scholar
30Maheux, R, Lemay, A, Blanchet, P, Friede, J, Pratt, X. Maintained reduction of uterine leiomyomata following addition of hormone replacement therapy to a monthly luteinizing hormone-releasing hormone agonist implant: a pilot study. Hum Reprod 1991; 6: 500–505.CrossRefGoogle ScholarPubMed
31Fogelman, I. Gonadotropin-releasing hormone agonists and the skeleton. Fertil Steril 1992; 57: 715–24.Google ScholarPubMed
32Matta, WH, Shaw, RW, Hesp, R, Katz, D. Hypogonadism induced by luteinizing hormone releasing hormone agonist analogues: effects on bone density in premenopausal women. Br Med J 1987; 294: 1523–24.CrossRefGoogle Scholar
33Dawood, MY, Lewis, V, Ramos, J. Cortical and trabecular bone mineral content in women with endometriosis: effects of gonadotropin-releasing hormone agonist and danazol. Fertil Steril 1989; 52: 21–26.CrossRefGoogle ScholarPubMed
34Johansen, JS, Riis, BJ, Hassanger, C, Moen, M, Jacobson, J, Christiansen, C. The effect of a gonadotropin-releasing hormone agonist analogue (nafarelin) on bone metabolism. J Clin Endocrinol Metab 1988; 67: 701–706.CrossRefGoogle ScholarPubMed
35Friedman, AJ. Vaginal haemorrhage associated with degenerating submucous leiomyomata during leuprolide acetate treatment. Fertil Steril 1989; 52: 152–54.CrossRefGoogle ScholarPubMed
36Thorp, JM, Katz, VL. Submucous myomas treated with gonadotropin-releasing hormone agonist and resulting in vaginal haemorrhage – a case report. J Reprod Med 1991; 36: 625–26.Google ScholarPubMed
37Healy, DL, Vollenhoven, BJ. The role of GnRH agonists in the treatment of uterine fibroids. Br J Obstet Gynaecol 1992; 99(supp 7): 23–26.CrossRefGoogle ScholarPubMed
38Chipato, T, Vollenhoven, BJ, Buckler, HM, Healy, DL. Pelvic pain complicating LHRH agonist treatment of fibroids. Aust N Z J Obstet Gynaecol 1991; 31: 383–84.CrossRefGoogle Scholar
39Ellenbogen, A, Shulman, A, Libai, Y, Jaschevatzky, O, Anderman, S, Grunstein, S. Complication of triptorelin treatment for uterine myomas. Lancet 1989; ii: 167–68.CrossRefGoogle Scholar
40Lee, MJ, Kazer, RR. Massive ascites after leuprolide acetate administration for the treatment of leiomyomata uteri. Fertil Steril 1991; 58: 416–18.CrossRefGoogle Scholar
41Lawson, TL, Albarelli, N. Diagnosis of gynecologic pelvic masses by gray scale ultrasonography: analysis of specificity and accuracy. Am J Roentgenol 1977; 128: 1003–1006.CrossRefGoogle ScholarPubMed
42Walsh, JW, Taylor, KJW, Wasson, JR McL, Schwartz, PE, Rosenfield, AT. Gray scale ultrasound in 204 proven gynecological masses: accuracy and specific diagnostic criteria. Radiology 1979; 130: 391–97.CrossRefGoogle Scholar
43Hricak, H, Tscholakoff, D, Heinrichs, L et al. Uterine leiomyomas: correlation of MR, histopathologic findings and symptoms. Radiology 1986; 158: 385–91.CrossRefGoogle ScholarPubMed
44Fedele, L, Bianchi, S, Dorta, M, Brioschi, D, Zanotti, F, Vercellini, P. Transvaginal ultrasonography versus hysteroscopy in the diagnosis of uterine submucous myomas. Obstet Gynecol 1991; 77: 745–48.Google ScholarPubMed
45Leibsohn, S, d'Ablaing, G, Mishell, DR, Schlaerth, JB. Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol 1990; 162: 968–74.CrossRefGoogle Scholar
46Meyer, WR, Mayer, AR, Diamond, MP, Carcangiu, ML, Schwartz, PE, DeCherney, AH. Unsuspected leiomyosarcoma: treatment with a gonadotropin-releasing hormone analogue. Obstet Gynecol 1990; 75: 529–32.Google ScholarPubMed
47Corscaden, JA, Singh, BP. Leiomyosarcoma of the uterus. Am J Obstet Gynecol 1958; 75: 149–53.CrossRefGoogle ScholarPubMed
48Loong, PL, Wong, FWS. Uterine leiomyosarcoma diagnosed during treatment with agonist of luteinizing hormone-releasing hormone for presumed uterine fibroid. Fertil Steril 1990; 54: 530–31.CrossRefGoogle ScholarPubMed
49Corson, SL, Brooks, PG. Resectoscopic myomectomy. Fertil Steril 1991; 55: 1041–44.CrossRefGoogle ScholarPubMed
50Hackenberg, R, Gesenhues, T, Deichert, U, Duda, V, Schmidt-Rhode, P, Schulz, KD. The response of GnRH agonist treatment can be predicted in most cases after one month. Eur J Obstet Gynecol Reprod Biol 1992; 45: 125–29.CrossRefGoogle ScholarPubMed
51Seki, K, Hoshihara, T, Nagatu, I. Leiomyosarcoma of the uterus: ultrasonography and serum lactate dehydrogenase level. Gynecol Obstet Invest 1992; 33: 114–18.CrossRefGoogle ScholarPubMed
52Matta, WHM, Stabile, I, Shaw, RW, Campbell, S. Doppler assessment of uterine blood flow changes in patients with fibroids receiving the gonadotropin-releasing hormone agonist buserelin. Fertil Steril 1988; 49: 1083–85.CrossRefGoogle ScholarPubMed
53Crow, J. Uterine fibroids: histological features. In: Shaw, RW ed. Uterine fibroids: time for review. Camforth, UK: The Parthenon Publishing Group, 1992: 21–33.Google Scholar
54Upadhyaya, MB, Doody, MC, Googe, PB. Histopathological changes in leiomyomata treated with leuprolide acetate. Fertil Steril 1990; 54: 811–14.CrossRefGoogle ScholarPubMed
55Uemura, T, Mori, J, Yoshimura, Y, Minaguchi, H. Treatment effects of GnRH agonists on the binding of estrogen and progesterone and the histological findings of uterine leiomyomas. Asia Oceania J Obstet Gynecol 1991; 17: 315–20.CrossRefGoogle ScholarPubMed
56Wilson, EA, Yang, F, Rees, ED. Estradiol and progesterone binding in uterine leiomyomata and in normal uterine tissues. Obstet Gynecol 1980; 55: 20–24.Google ScholarPubMed
57Soules, MR, McCarty, KS. Leiomyomas: steroid receptor content. Variation within normal menstrual cycles. Am J Obstet Gynecol 1982; 143: 6–11.CrossRefGoogle ScholarPubMed
58Lumsden, MA, West, CP, Hawkins, TA, Bramley, TA, Rumgay, L, Baird, DT. The binding of steroids to myometrium and leiomyomata (fibriods) in women treated with the gonadotrophin-releasing hormone agonist, Zoladex (ICI 118640). J Endocrinol 1989; 121: 389–96.CrossRefGoogle Scholar
59Rein, MS, Friedman, AJ, Stuart, JM, MacLaughlin, DT. Fibroid and myometrial steroid receptors in women treated with gonadotropin-releasing hormone agonist leuprolide acetate. Fertil Steril 1990; 53: 1018–23.CrossRefGoogle ScholarPubMed
60Farber, M, Conrad, S, Heinrichs, W, Herrmann, W. Estradiol binding by fibroid tumours and normal myometrium. Obstet Gynecol 1972; 40: 479–86.Google ScholarPubMed
61Neuman, M, Langer, R, Golan, A, Bukovsky, I, Caspi, E, Koch, Y. Gonadotropin-releasing hormone (GnRH) action on uterine leiomyomata is not mediated by uterine GnRH receptors. Fertil Steril 1991; 56: 364–66.CrossRefGoogle Scholar
62Deuel, TF. Polypeptide growth factors: roles in normal and abnormal cell growth. Ann Rev Cell Biol 1987; 3: 445–92.CrossRefGoogle ScholarPubMed
63Hofman, GE, Rao, CHV, Barrows, GH, Schutz, GS, Sanfilippo, JS. Binding sites for epidermal growth factor in human uterine tissue and leiomyomas. J Clin Endocrinol Metab 1984; 58: 880–84.CrossRefGoogle Scholar
64Lumsden, MA, West, CP, Bramley, TA, Rumgay, L, Baird, DT. The binding of epidermal growth factor to the human uterus and leiomyomata in women rendered hypo-oestrogenic by continuous administration of an LHRH agonist. Br J Obstet Gynaecol 1988; 95: 1299–1304.CrossRefGoogle Scholar
65Tommola, P, Pekonen, F, Rutaran, EM. Binding of epidermal growth factor and insulin-like growth factor I in human myometrium and leiomyoma. Obstet Gynecol 1989; 74: 658–62.Google Scholar
66Rein, MS, Friedman, AJ, Pandian, MR, Heffner, LJ. The secretion of insulin-like growth factors I and II by explant cultures of fibroids and myometrium from women treated with a gonadotropin-releasing hormone agonist. Obstet Gynecol 1990; 76: 388–94.Google ScholarPubMed
67Dicker, RC, Greenspan, JR, Strauss, LT et al. Complications of abdominal hysterectomy among women of reproductive age in the United States. The collaborative review of sterilisation. Am J Obstet Gynecol 1982; 144: 841–48.CrossRefGoogle Scholar
68Vessey, MP, Villard Mackintosh, L, Coulter, A, Yeates, D. The epidemiology of hysterectomy: findings in a large cohort study. Br J Obstet Gynaecol 1992; 99: 402–407.CrossRefGoogle Scholar
69Lumsden, MA, West, CP, Baird, DT: Goserelin therapy before surgery for uterine fibroids. Lancet; i: 36–37.Google Scholar
70Lumsden, MA, Thomas, E, Coutts, JRT, West, CP, Baird, T. Goserelin pretreatment facilitates abdominal hysterectomy for the removal of uterine leiomyomata (fibroids). Gynecol Endocrinol 1990; 4(suppl 2):41.Google Scholar
71West, CP, Lumsden, MA, Baird, DT. Goserelin (Zoladex®) in the treatment of fibroids. Br J Obstet Gynaecol 1992; 99(suppl 7): 27–30.CrossRefGoogle ScholarPubMed
72Stovall, TG, Ling, FW, Henry, LC, Woodruff, R. A randomised trial evaluating leuprolide acetate before hysterectomy as treatment for leiomyomas. Am J Obstet Gynecol 1991; 164: 1420–23.CrossRefGoogle ScholarPubMed
73Fedele, L, Bianchi, S, Baglioni, A, Arcaini, L, Marchini, M, Bocciolone, L. Intranasal buserelin versus surgery in the treatment of uterine leiomyomata: long-term follow-up. Eur J Obstet Gynecol Reprod Blol 1991; 38: 53–57.CrossRefGoogle ScholarPubMed
74Candiani, GB, Vercellini, P, Arcaini, L, Bianchi, S, Candiani, M. Use of goserelin depot, a gonadotropin-releasing hormone agonist for the treatment of menorrhagia and severe anaemia in women with leiomyomata uteri. Acta Obstet Gynaecol Scand 1990; 69: 413–15.CrossRefGoogle ScholarPubMed
75Verkauf, BS. Myomectomy for fertility enhancement and preservation. Fertil Steril 1992; 58: 1–15.Google ScholarPubMed
76Gardner, RL, Shaw, RW. GnRH agonists and blood loss at surgery. In: Shaw, RW ed. Uterine fibroids: time for review. Carnforth, UK: The Parthenon Publishing Group, 1992: 123–34.Google Scholar
77Fedele, L, Vercellini, P, Bianchi, S, Brioschi, D, Dorta, M. Treatment with GnRH agonists before myomectomy and the risk of short term myoma recurrence. Br J Obstet Gynaecol 1990; 97: 393–96.CrossRefGoogle ScholarPubMed
78Friedman, AJ, Rein, MS, Harrison-Atlas, D, Garfield, JM, Doubilet, PM. A randomised, placebo-controlled, double-blind study evaluating leuprolide acetate depot treatment before myomectomy. Fertil Steril 1989; 52: 728–33.CrossRefGoogle ScholarPubMed
79Friedman, AJ, Daly, M, Juneau-Norcross, M, Fine, C, Rein, MS. Recurrence of myomas after myomectomy in women pretreated with leuprolide acetate depot or placebo. Fertil Steril 1992; 59: 205–208.CrossRefGoogle Scholar
80Neuwirth, RS. Hysteroscopic management of symptomatic submucus uterine fibroids. Obstet Gynecol 1983; 62: 509–11.Google Scholar
81Donnez, J, Schrurs, B, Gillerot, S, Sandow, J, Clerckx, F. Treatment of uterine fibroids with implants of gonadotropin-releasing hormone agonist: assessment by hysterography. Fertil Steril 1989; 51: 947–50.CrossRefGoogle ScholarPubMed
82Donnez, J, Gillerot, S, Bourgonjon, D, Clerckx, F, Nisolle, M. Neodymium: YAG laser hysteroscopy in large submucous fibroids. Fertil Steril 1990; 54: 999–1003.CrossRefGoogle ScholarPubMed
83Donnez, J, Nisolle, M, Grandjean, P, Gillerot, S, Clerckx, F. The place of GnRH agonists in the treatment of endometriosis and fibroids by advanced hysteroscopic techniques. Br J Obstet Gynaecol 1991; 99(suppl 7): 31–33.CrossRefGoogle Scholar
84Derman, SG, Rehnstrom, J, Neuwirth, RS. The long-term effectiveness of hysteroscopic treatment of menorrhagia and leiomyomas. Obstet Gynecol 1991; 77: 591–94.Google ScholarPubMed
85Semm, K, Mettler, L. Technical progress in pelvic surgery via operative laparoscopy. Am J Obstet Gynecol 1980; 138: 121–27.CrossRefGoogle ScholarPubMed
86Dubuisson, JB, Lecuru, F, Foulot, H, Mandelbrot, L, Aubriot, FX, Mouly, M. Myomectomy by laparoscopy; a preliminary report of 43 cases. Fertil Steril 1991; 56: 827–30.CrossRefGoogle ScholarPubMed
87Goldfarb, HA. Nd:YAG laser laparoscopic coagulation of symptomatic myomas. J Reprod Med 1992; 37: 636–38.Google ScholarPubMed
88Friedman, AJ. Treatment of leiomyomata uteri with short-term leuprolide followed by oestrogen-progestin hormone replacement therapy for two years: a pilot study. Fertil Steril 1989; 51: 526–28.CrossRefGoogle Scholar
89Maheux, R, Lemay, A. Treatment of perimenopausal women: potential long-term therapy with a depot GnRH agonist combined with hormone replacement therapy. Br J Obstet Gynaecol 1992; 99 (suppl 7): 13–17.CrossRefGoogle Scholar
90Lumsden, MA, West, CP, Baird, DT: Tamoxifen prolongs luteal phase in premenopausal women but has no effect on the size of uterine fibroids. Clin Endocrinol 1989; 31: 335–43.CrossRefGoogle ScholarPubMed
91Lumsden, MA, West, CP, Hillier, H, Baird, DT. Estrogenic action of tamoxifen in women treated with luteinizing hormone-releasing hormone agonists (goserelin) – a lack of shrinkage of uterine fibroids. Fertil Steril 1989; 52: 924–29.CrossRefGoogle ScholarPubMed
92McDonald, CC, Stewart, HJ. (Scottish Breast Cancer Committee.) Fatal myocardial infarction in the Scottish adjuvant tamoxifen trial. Br Med J 1991; 303: 435–37.CrossRefGoogle ScholarPubMed
93Turner, RT, Wakley, GK, Hannon, KS, Bell, NH: Tamoxifen inhibits osteoclast-mediated resorption of trabecular bone in ovarian hormone-deficient rats. Endocrinology 1988; 122: 1146–50.CrossRefGoogle ScholarPubMed
94Turkin, S, Siris, E, Seldin, D, Laster, E, Hyman, G, Lindsay, R. Effects of tamoxifen on spinal bone density in women with breast cancer. J Natl Cancer Inst 1989; 81: 1086–88.CrossRefGoogle Scholar
95Lindsay, R, Hart, DM, Purdie, D, Ferguson, MM, Clark, AS, Kraszewski, A. Comparative effects of oestrogen and progestogen on bone loss in postmenopausal women. Clin Sci Mol Med 1978; 54: 193–95.Google Scholar
96Mandel, FP, Davidson, BJ, Erlik, Y, Judd, HL, Meldrum, DR. Effects of progestins on bone metabolism in postmenopausal women. J Reprod Med 1982; 27: 511–14.Google Scholar
97Goldzieher, JW, Maqueo, M, Ricard, L, Aquilar, JA, Canales, E. Induction of degenerative changes in uterine myomas by high dose progestin therapy. Am J Obstet Gynecol 1966; 96: 1078–87.CrossRefGoogle Scholar
98Friedman, AJ, Barbieri, RL, Doubilet, PM, Fine, C, Schiff, I. A randomised double blind trial of a gonadotrophin releasing hormone agonist (leuprolide) with or without medroxyprogesterone acetate in the treatment of leiomyomata uteri. Fertil Steril 1988; 49: 404–409.CrossRefGoogle ScholarPubMed
99West, CP, Lumsden, MA, Millier, H, Sweeting, V, Baird, DT. Potential role for medroxyprogesterone acetate as an adjunct to goserelin (Zoladex) in the medical management of uterine fibroids. Hum Reprod 1992; 7: 328–32.CrossRefGoogle ScholarPubMed
100Benagiano, G, Morini, A, Aleandri, F et al. Sequential Gn-RH superagonist and medroxyprogesterone acetate treatment of uterine leiomyomata. Int J Obstet Gynecol 1990; 33: 333–43.CrossRefGoogle ScholarPubMed
101Bayard, F, Damilano, S, Robel, P, Baulieu, EE. Cytoplasmic and nuclear oestradiol and progesterone receptors in human endometrium. J Clin Endocrinol Metab 1978; 46: 635–48.CrossRefGoogle ScholarPubMed
102Tseng, L, Gurpide, E. Effect of progestins on estradiol receptors in human endometrium. J Clin Endocrinol Metab 1975; 41: 402–404.CrossRefGoogle ScholarPubMed
103Nakamura, Y, Yoshimura, Y, Yamada, H, Ubukata, Y, Ando, M, Suzuki, M. Treatment of leiomyomata with a luteinizing hormone-releasing hormone agonist: the possibility of non-surgical management in selected perimenopausal women. Fertil Steril 1991; 55: 900–905.CrossRefGoogle Scholar
104Gardner, RL, Shaw, RW. Cornual fibroids: a conservative approach to restoring tubai patency using a gonadotropin-releasing hormone agonist (goserelin) with successful pregnancy. Fertil Steril 1989; 52: 332–34.CrossRefGoogle ScholarPubMed
105Naether, O, Diedrich, K. Intrauterine pregnancy with uterine myoma after downregulation with GnRH analogues. Geburtshilfe Frauenheilkd 1992; 52: 121–22.CrossRefGoogle Scholar
106Volpe, A, Adamo, R, Coukos, G, Silferi, M, Artini, PG, Genazzani, AR. Pregnancy following regression of uterine submucosal leiomyoma with GnRH therapy: a case report. Eur J Obstet Gynecol Reprod Biol 1991; 39: 223–25.CrossRefGoogle ScholarPubMed
107Blumenfeld, Z, Enat, R, Brandes, JM, Baruch, Y. Gonadotropin-releasing hormone analogues for dysfunctional bleeding in women after liver transplantation: a new application. Fertil Steril 1992; 57: 1121–23.CrossRefGoogle ScholarPubMed
108Shikora, SA, Niloff, JM, Bistrian, BR, Forse, RA, Blackburn, GL. Relationship between obesity and leiomyomata. Nutrition 1991; 7: 251–55.Google ScholarPubMed
109Reiter, RC, Wagner, PL, Gambone, JC. Routine hysterectomy for asymptomatic uterine fibroids: a reappraisal. Obstet Gynecol 1992; 79: 481–84.Google ScholarPubMed