Effects of combined GnRH receptor antagonist linzagolix and hormonal add-back therapy on vaginal bleeding—delayed add-back onset does not improve bleeding pattern

Oliver Pohl, Line Marchand, David Bell, Jean-Pierre Gotteland, Jean‐Pierre Gotteland
Reproductive sciences (Thousand Oaks, Calif.) · 2020 · vol. 27(4) , pp. 988–995 · doi:10.1007/s43032-020-00172-z · PMID:32100275 · W3008541467
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-08 ⓘ

Combined linzagolix and hormonal add-back therapy achieved better bleeding control and fewer hot flushes than delayed add-back in healthy premenopausal women.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This single-center, open-label, parallel-group study in 32 premenopausal women evaluated high-dose linzagolix (200 mg) with hormonal add-back therapy (ABT) versus a delayed ABT onset, using 10 weeks of combined linzagolix/ABT or 4 weeks of linzagolix alone followed by ABT for 6 additional weeks. Linzagolix alone rapidly reduced bleeding, achieving amenorrhea in all women by week 5, with trough estradiol (E2) levels reaching median week 4 values of 4.1 pg/mL. When ABT was started at week 5, spotting and bleeding occurred, and bleeding was more frequent in the “Combined-ABT” group than in the “Delayed-ABT” group, with E2 medians of 24–32 pg/mL early in the combined group versus 35–42 pg/mL during weeks 5–10 in the delayed group; the paper reports that linzagolix was well tolerated, with headache and hot flushes as the most frequent adverse events. The main limitation is the small sample size and open-label design using healthy women rather than patients with sex-hormone-dependent disease. This paper is centrally about endometriosis — it evaluates linzagolix, a GnRH receptor antagonist developed for endometriosis, and characterizes how different add-back timing affects bleeding and estradiol relevant to endometriosis treatment regimens.

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MeSH descriptors

Estradiol Receptors, LHRH Uterine Hemorrhage Adolescent Adult Amenorrhea Amenorrhea Estradiol Estradiol Female Humans Middle Aged Progesterone Progesterone Receptors, LHRH Treatment Outcome Uterine Hemorrhage Young Adult

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