title: The role of add-back therapy in the United States.
abstract: Gonadotropin-releasing hormone (GnRH) agonists are effective in reducing pelvic pain due to endometriosis, but they are associated with a number of hypoestrogenic side effects, such as vasomotor symptoms and loss of bone mineral density. Add-back therapy with a progestin or a progestin plus low-dose estrogen helps to reduce the side effects associated with GnRH agonist administration without compromising efficacy. Add-back therapy should be initiated at the same time as the treatment with a GnRH agonist and longer-term therapy beyond 6 months can be considered in patients meeting the appropriate criteria.
authors.affiliation: Department of Obstetrics and Gynecology, University of Wisconsin-Madison School of Medicine, Madison, Wisconsin, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Olive
mesh_terms: D004715:Endometriosis / Q000150:complications / Q000188:drug therapy*; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D017699:Pelvic Pain / Q000188:drug therapy* / Q000209:etiology; D011372:Progestins / Q000008:administration & dosage; D014481:United States
chemical_list: D004967:Estrogens; D011372:Progestins; D007987:Gonadotropin-Releasing Hormone