title: The combination of a depot gonadotrophin releasing hormone agonist and cyclical hormone replacement therapy for dysfunctional uterine bleeding.
abstract: OBJECTIVE
  To observe if a combination of a depot GnRH agonist and cyclical hormone replacement therapy decreases menstrual blood loss.
  
  
  METHODS
  An open, observational study comparing the objective assessment of menstrual blood loss before, during and after 3 months treatment.
  
  
  METHODS
  20 women with a subjective complaint of heavy menstrual loss in whom no cause could be discovered.
  
  
  METHODS
  Each woman received 3 months of depot goserelin (Zoladex) combined with cyclical hormone replacement therapy (Cyclo-Progynova, 1 mg). Menstrual loss and symptoms were assessed before, throughout and after the study.
  
  
  METHODS
  Changes in objective and subjective assessments of menstrual blood loss and the acceptability of the treatment.
  
  
  RESULTS
  The median pretreatment menstrual loss was 68 ml (range 23-397). Only 8 (40%) of the patients had a loss exceeding 80 ml per period. The median blood loss was 30 ml, 16 ml, and 17 ml in the three treatment cycles (P less than 0.001 Wilcoxon rank sum for the third cycle). There was a significant decrease in the median length of menstruation (P less than 0.001) and the number of towels or tampons (P less than 0.01) used per period in the third treatment cycle. There was a significant decrease (P less than 0.005) in the number of women complaining of dysmenorrhoea, premenstrual symptoms, flooding and the passage of clots. Seventeen patients experienced hot flushes. Eighteen of the 20 patients were completely satisfied with the treatment and would have been happy to continue with it for longer than 12 months.
  
  
  CONCLUSIONS
  The combination of a depot gonadotrophin releasing hormone agonist and cyclical hormone replacement therapy is a successful and acceptable treatment of dysfunctional uterine bleeding.
authors.affiliation: Department of Obstetrics and Gynaecology, Newcastle General Hospital, Newcastle-upon-Tyne.
authors.forename: E J
authors.initials: EJ
authors.lastname: Thomas
authors.forename: K J
authors.initials: KJ
authors.lastname: Okuda
authors.forename: N M
authors.initials: NM
authors.lastname: Thomas
mesh_terms: D000328:Adult; D002064:Buserelin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D017273:Goserelin; D006801:Humans; D007279:Injections, Subcutaneous; D008595:Menorrhagia / Q000188:drug therapy*; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D017273:Goserelin; D004958:Estradiol; D002064:Buserelin