Spontaneous reversibility of bone loss induced by gonadotropin-releasing hormone analog treatment.
OBJECTIVE
To verify if a 6-month period of hypoestrogenism due to chronic treatment with GnRH analogue (GnRH-a) causes irreversible bone loss in young women.


METHODS
Controlled clinical study in volunteer women.


METHODS
Department of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy.


METHODS
Twenty-eight women (mean age +/- SE 81.1 +/- 0.99 years) with endometriosis diagnosed by laparoscopy and 25 healthy, normally cycling women of the same age (28.3 +/- 1.14 years).


METHODS
In women with endometriosis, six SC implants of the GnRH-a compound, 3.6 mg goserelin acetate depot, were administered every 28 days starting within 15 days of laparoscopy. Compounds interfering with bone metabolism or hormonal formulations were not taken by control women during the entire period of the study.


METHODS
Evaluation of lumbar bone mineral density at the start of the study and 6, 12, and 30 months later.


RESULTS
At the onset of the study, lumbar bone mineral density did not differ in women with endometriosis and control women. Lumbar bone mineral density values significantly decreased after 6 months of GnRH-a treatment. This reduction was still evident 6 months after GnRH-a interruption. However, 24 months after treatment withdrawal, bone mineral density reduction disappeared and bone mineral density values were completely superimposable (+/- O.4 percent) to those observed before treatment. In contrast, control women lumbar bone mineral density values did not change during the entire period of observation.


CONCLUSIONS
These data suggest that GnRH-a treatment for 6 months is not associated with long-term effects on lumbar bone density.
Paoletti
A M
AM
Istituto di Ginecologia Ostetricia e Fisiopatologia della Riproduzione Umana, Università degli Studi di Cagliari, Cagliari, Italy.
Serra
G G
GG
Cagnacci
A
A
Vacca
A M
AM
Guerriero
S
S
Solla
E
E
Melis
G B
GB
D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects*; D004343:Drug Implants; D004715:Endometriosis / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D017273:Goserelin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced*; D013997:Time Factors
D018931:Antineoplastic Agents, Hormonal; D004343:Drug Implants; D017273:Goserelin; D007987:Gonadotropin-Releasing Hormone