The Skeletal Effects of Gonadotropin-Releasing Hormone Antagonists: A Concise Review

Mohamad NV, Nur-Vaizura Mohamad, Ima-Nirwana S, Soelaiman Ima-Nirwana, Chin KY, Kok-Yong Chin
Endocrine, metabolic & immune disorders drug targets · 2021 · vol. 21(10) , pp. 1713–1720 · doi:10.2174/1871530321666201216164410 · PMID:33327926
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⚙ AI-generated summary by qwen3.7-flash, 2026-10-04 ⓘ

This review examines the skeletal effects of GnRH antagonists, noting their use in endometriosis and prostate cancer, and reports that these drugs cause significant bone loss and increased fracture risk.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-09-24 · read from full text ⓘ

This concise review examines the skeletal impacts of Gonadotropin-Releasing Hormone (GnRH) antagonists, which are used to treat hormone-dependent conditions by suppressing sex hormones. While animal studies indicate deterioration of bone microstructure, human clinical trials demonstrate significant bone loss at the spine, hip, and femur among patients receiving these agents. The authors highlight that this accelerated bone loss leads to osteoporosis and fragility fractures, emphasizing the critical need for early preventive measures to mitigate associated morbidity. Relevance to endometriosis: GnRH antagonists are listed as an effective treatment for endometriosis in the abstract, though the paper's primary focus is on the resulting bone health risks rather than the disease pathology itself.

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Abstract

Prolonged treatment with Gonadotropin-Releasing Hormone (GnRH) agonists is known to induce bone loss among prostate cancer patients. However, evidence on the skeletal effects of GnRH antagonists is relatively less well-known. This review aims to examine the effects of GnRH antagonists on bone health. GnRH antagonists are an effective treatment for hormone-dependent conditions, such as advanced prostate cancer and endometriosis. They induce a competitive and reversible GnRH-receptor blockage, thereby suppressing the release of gonadotropins and sex hormones. The sex hormone ablation results in undesirable side effects, including accelerated bone loss. In animal studies, treatment with GnRH antagonists is reported to cause deterioration of bone microstructure. Human clinical trials revealed significant bone loss at the spine, hip and femur in patients treated with GnRH antagonists. Thus, osteoporosis and the resultant fragility fractures pose a significant impact on health and quality of life of GnRH antagonist users. Thus, early preventive measures of bone loss are critical in preventing fractures and its associated morbidity in these patients.
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Abstract

Prolonged treatment with Gonadotropin-Releasing Hormone (GnRH) agonists is known to induce bone loss among prostate cancer patients. However, evidence on the skeletal effects of GnRH antagonists is relatively less well-known. This review aims to examine the effects of GnRH antagonists on bone health. GnRH antagonists are an effective treatment for hormone-dependent conditions, such as advanced prostate cancer and endometriosis. They induce a competitive and reversible GnRH-receptor blockage, thereby suppressing the release of gonadotropins and sex hormones. The sex hormone ablation results in undesirable side effects, including accelerated bone loss. In animal studies, treatment with GnRH antagonists is reported to cause deterioration of bone microstructure. Human clinical trials revealed significant bone loss at the spine, hip and femur in patients treated with GnRH antagonists. Thus, osteoporosis and the resultant fragility fractures pose a significant impact on health and quality of life of GnRH antagonist users. Thus, early preventive measures of bone loss are critical in preventing fractures and its associated morbidity in these patients.

Keywords

Bone mineral density, estrogen, fracture, osteoporosis, sex hormones, testosterone. 67

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Condition tags

endometriosis

MeSH descriptors

Bone and Bones Gonadotropin-Releasing Hormone Animals Animals Bone and Bones Bone and Bones Bone and Bones Bone Density Bone Density Bone Density Endometriosis Endometriosis Endometriosis Endometriosis Female Female Fractures, Bone Fractures, Bone Fractures, Bone Fractures, Bone

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