The Use of GnRH Analogues to Control Menstrual Bleeding

In: GnRH Analogues in Cancer and Human Reproduction · 1990 · pp. 49–60 · doi:10.1007/978-94-009-2169-6_7 · W4255427198
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Increased understanding of menstrual bleeding mechanisms has led to new approaches, such as GnRH analogues, to control excessive or disordered menstrual flow.

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This 1990 chapter reviews how improved understanding of the mechanisms regulating menstrual blood flow has led to new approaches for controlling excessive or disordered menstrual bleeding, focusing on the use of GnRH (LHRH) analogues to suppress reproductive endocrine activity. It discusses high-level evidence from physiological and primate studies and includes clinical experience with intranasal GnRH analogues, noting their effects on cyclic ovarian function and endometrium, and references work on uterine blood flow changes and treatment-related hypogonadism. A key limitation highlighted by the chapter context is that evidence spans different models and outcomes rather than providing a single, uniform controlled clinical result for all bleeding disorders. Relevance to endometriosis: the chapter cites prior work on intranasal LHRH agonist treatment in women with endometriosis (B M J 1983), though its main focus is broadly controlling menstrual bleeding with GnRH analogues.

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Abstract

A substantial proportion of General Practitioner consultations and gynaecological referrals concern disorders of menstrual bleeding. In the last decade an increased understanding of the mechanisms which initiate and regulate menstrual blood flow have resulted in new approaches to endeavour to control excessive or disordered menstrual bleeding. Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

Markee, JE (1940). Menstruation in intraocular endometrial transplants in the rhesus monkey. Contr Embryol Carn Ins, 28, 219 Pickles, VR, and Hall, WJ (1963). Some physiological properties of the menstrual stimulant substances A1 and A2. J Reprod Fertil, 6, 315 Abel, M (1979). Production of prostaglandins by the human uterus: are they involved in menstruation? Res Clinic Forums, 1, 33 Smith, SK, Abel, MH, Kelly, RW, and Baird, DT (1981). Prostaglandin synthesis in the endometrium of women with ovular dysfunctional uterine bleeding. Brit J Obstet Gynaecol, 88, 434 Hamberg, M, and Samuellsson B (1974). Prostaglandin endoperoxides. Novel transformations of arachidonic acid in human platelets. Proc Natl Acad Sci USA, 71, 3400 Fraser, HM, Laird, NC, and Blakeley, DM (1980). Decreased pituitary responsiveness and inhibition of the luteinizing hormone surge and ovulation in the stumptailed monkey (Macaca arrctoides) by chronic treatment with an agonist of luteinizing hormonereleasing hormone. Endocrinology, 115, 1780 Bergquist, C, Nillius, SJ, and Wide, L (1982). Long-term intranasal luteinizing hormone-releasing hormone agonist treatment for contraception in women. Fertil Steril, 38, 190 Schmidt-Gollwitzer, M, Hardt, W, Schmidt-Gollwitzer, K, Von der Ohne, M, and Nevinny-Stickel, J (1981). Influence of the LH-RH analogue buserelin on cyclic ovarian function and on endometrium. A new approach to fertility control? Contraception, 23, 187 Pedroza E, Vilchez-Martinez, JA, Coy, DH, Arimura, A, and Schally, AV (1978). Correlation between in vivo inhibition of gonadotrophin release induced by LHRH and the blockade of ovulation by synthetic analogues of LHRH. Int J Fertil, 23, 294 Fraser, HM, and Shaw, RW (1984). Effects of chronic luteinizing hormone-releasing hormone agonist treatment in dysfunctional uterine bleeding in the stumptailed macaque. Acta Endocrinol, 106, 381 Bergquist, C, Nillius, SJ, Wide, L, and Lindgren, A (1981). Endometrial patterns in women on chronic luteinizing hormonereleasing hormone agonist treatment for contraception. Fertil Steril, 36, 339 Hallberg, L, and Nilsson, L (1964). Determination of menstrual blood loss. Scand J Clin Lab Invest, 16, 244 Shaw, RW, Fraser, HM, and Boyle, H (1983). Intranasal LHRH agonist treatment in women with endometriosis. Brit Med J, 287. 1667 Matta, WH, Shaw, RW, Hesp, R, and Katz, D (1987). Hypogonadism induced by luteinizing hormone releasing hormone agonist analogues: effects on bone density in pre-menopausal women. Brit Med J, 294, 1523 Matta, WH, Stabile, I, Shaw, RW, and Campbell, S (1988). Doppler assessment of uterine blood flow changes in patients with fibroids receiving the gonadotrophin-releasing hormone agonist buserelin. Fertil Steril (in press) Author information Authors and Affiliations Editor information Editors and Affiliations Rights and permissions Copyright information © 1990 Springer Science+Business Media Dordrecht About this chapter Cite this chapter Shaw, R.W. (1990). The Use of GnRH Analogues to Control Menstrual Bleeding. In: Vickery, B.H., Lunenfeld, B. (eds) GnRH Analogues in Cancer and Human Reproduction. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-2169-6_7 Download citation DOI: https://doi.org/10.1007/978-94-009-2169-6_7 Publisher Name: Springer, Dordrecht Print ISBN: 978-94-010-7474-2 Online ISBN: 978-94-009-2169-6 eBook Packages: Springer Book Archive

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