Impact of six months of GnRH agonist therapy for endometriosis. Is there an age-related effect on bone mineral density?
OBJECTIVE
To determine if there is an age-related effect on bone mineral density (BMD) loss with GnRH agonist treatment of endometriosis and, in particular, whether the impact of this therapy in terms of BMD loss is different if it is used at an age prior to attainment of peak BMD than after attaining it.


METHODS
Data from a randomized, double-placebo-controlled clinical trial comparing efficacy and safety of two GnRH agonists, without add-back, for the treatment of endometriosis, were analyzed.


RESULTS
No significant age-related effect was detected for either GnRH agonist on absolute BMD loss with a single, six-month course. However, in women at an age prior to peak BMD, prevention of the natural increase in BMD with these drugs may prevent women from attaining their peak BMD and thus increase their risk of osteoporosis in later life.


CONCLUSIONS
GnRH agonists should be used with caution and perhaps only with strategies designed to minimize the impact on BMD in women prior to attainment of peak BMD.
Agarwal
Sanjay K
SK
Departments of Obstetrics and Gynecology, Burns and Allen Research Institute, Cedars-Sinai Medical Center, University of California-Los Angeles School of Medicine, Los Angeles, USA. agarwals@cshs.org
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015519:Bone Density / Q000187:drug effects; D004311:Double-Blind Method; D004715:Endometriosis / Q000188:drug therapy*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D016729:Leuprolide / Q000009:adverse effects* / Q000494:pharmacology; D008875:Middle Aged; D017274:Nafarelin / Q000009:adverse effects* / Q000494:pharmacology; D010024:Osteoporosis / Q000139:chemically induced*; D016032:Randomized Controlled Trials as Topic
D017274:Nafarelin; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide