The role of add-back therapy in the United States
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Add-back therapy with progestin or progestin plus estrogen mitigates hypoestrogenic side effects of GnRH agonists for endometriosis without reducing efficacy.
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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.
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Cited by (7)
- Oral continuous combined 0.5 mg estradiol valerate and 5 mg dydrogesterone as daily add-back therapy during post-operative GnRH agonist treatment for endometriosis in Chinese women 2013
- Quality of life according to add-back therapy during GnRH agonist treatment in endometriosis patients 2012
- The hormonal profile of norethindrone acetate: rationale for add-back therapy with gonadotropin-releasing hormone agonists in women with endometriosis 2012
- Endometriosis and abdominal myofascial pain in adults and adolescents 2011
- Gonadotropin-releasing hormone agonists for endometriosis 2008
- Investigating endometriosis: symptoms, diagnosis and treatment 2006
- The role of laparoscopic surgery in current treatment of endometriosis 2006
Source provenance
- europepmc
- last seen: 2026-10-14T06:08:39.101224+00:00
- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-10-08T21:03:24.829172+00:00
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