Prolonged use of gonadotropin-releasing hormone agonist and tibolone as add-back therapy for the treatment of endometrial hyperplasia

Θεόδωρος Αγοραστός, Theodoros Agorastos, Violetta Vaitsi, Minas Paschopoulos, Andromache Vakiani, Vassiliki Zournatzi-Koiou, Haris Saravelos, H. Saravelos, Evanthia Kostopoulou, Theodoros Constantinidis, Theodoros C. Constantinidis, Konstantinos Dinas, Dimitrios Vavilis, Dimitrios Lolis, J. Bontis, John Bontis
Maturitas · 2003 · vol. 48(2) , pp. 125–132 · doi:10.1016/j.maturitas.2003.08.008 · PMID:15172086 · W2109640284
Non-randomised trial OA: closed CC0 ⤵ 9 in-corpus citations
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This study investigated the efficacy and safety of using a GnRH agonist with tibolone as add-back therapy for treating endometrial hyperplasia.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

OBJECTIVES: To investigate the response of the various hyperplastic disorders of the endometrium to a prolonged treatment with leuprolide acetate, a gonadotropin-releasing hormone agonist (GnRH-a), plus tibolone, as add-back therapy, and further to study if the tibolone addition reduces the hypoestrogenic actions of the GnRH-analogue. METHODS: We treated 26 women with histologically confirmed simple (n = 9), complex (n = 15) or atypical (n = 2) endometrial hyperplasia (EH) for 12 months with monthly injections of 1Ampulle/3.75 mg of leuprolide acetate, followed by tibolone, 2.5mg per day per os. Every woman underwent a hysteroscopic evaluation and biopsy of the endometrium after 3 (in cases with atypical EH), 6 and 12 months of treatment, as well as after 12 and 24 months of follow-up. The clinical, paraclinical and laboratory course of the disease was followed-up by using of a climacteric scoring system and by testing of various parameters. RESULTS: The histopathologic evaluation of the endometria revealed regression of EH in all women after 12 months of treatment, however, during the first 2 years of follow-up EH reappeared in four women (4/21, 19%). Bone mineral density and serum parameters did not show significant changes during treatment, whereas only a mild suffering from hypoestrogenic side-effects was noted. CONCLUSIONS: It seems that the combined GnRH-a/tibolone treatment in women with EH is a potent alternative, so far as the endometrial status and the clinical course of the disease are concerned, whereas tibolone appears to act sufficiently as add-back therapy to prolonged GnRH-a treatment. The probability of relapse of the disease during the follow-up period makes the close monitoring of the endometrium after cessation of the treatment absolutely necessary.

My notes (saved in your browser only)

MeSH descriptors

Endometrial Hyperplasia Estrogen Receptor Modulators Gonadotropin-Releasing Hormone Leuprolide Norpregnenes Adult Drug Therapy, Combination Endometrial Hyperplasia Endometrial Hyperplasia Estrogen Receptor Modulators Female Gonadotropin-Releasing Hormone Humans Injections Leuprolide Middle Aged Norpregnenes Treatment Outcome

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (27)

Cited by (9)

Source provenance

openalex
last seen: 2026-05-14T06:09:40.812857+00:00
pubmed
last seen: 2026-10-08T21:02:29.018211+00:00
unpaywall
last seen: 2026-10-13T06:25:51.201866+00:00
License: CC0 · commercial use OK