Effect of goserelin in quality of life of women with abnormal uterine bleeding and leiomyoma: a case series

Alda Luiza Alves Silva, Isabela Maciel Caetano, Diana Cupertino Milagres, Admário Silva Santos Filho, Maurício Bechara Noviello, Pedro Luiz Maciel Caetano
In: Brazilian Journal of Health Review · 2023 · vol. 6(1) , pp. 715–727 · doi:10.34119/bjhrv6n1-056 · W4316286501
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Goserelin treatment improved quality of life in women with abnormal uterine bleeding due to leiomyomas, despite common side effects like hot flushes and vaginal dryness.

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This retrospective case series evaluated the impact of goserelin, a gonadotrophin-releasing hormone agonist, on the quality of life for twenty-three women suffering from abnormal uterine bleeding and leiomyomas. Participants completed the Uterine Fibroid Symptom and Quality of Life questionnaire before and after treatment, revealing significant improvements across all symptom severity and health-related quality of life domains. While the intervention successfully induced amenorrhea in most participants and alleviated fibroid symptoms, it was associated with common adverse effects, including hot flushes and vaginal dryness. Relevance to endometriosis: Goserelin is listed in the references as a treatment for severe endometriosis, but this paper specifically focuses on leiomyoma rather than endometriosis or adenomyosis.

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Abstract

Leiomyomas are a major source of morbidity and decrease in quality of life for women of reproductive age. Goserelin is a Gonadotrophin-releasing hormone agonist (GnRHa) which treats leiomyomas inducing a hypogonadotropic state. Adverse effects includes hot flushes and vaginal dryness. When choosing a treatment, its capability to improve the patient’s quality of life must be taken in consideration. The objective of this retrospective case series was to study the impact of Goserelin in the quality of life of women with leiomyomas and abnormal uterine bleeding refractory to hormonal contraceptives. In this study, twenty-three women with abnormal uterine bleeding due to leiomyoma who were treated with Goserelin at two tertiary public teaching hospitals from Brazil answered the UFS-QoL regarding their leiomyoma symptoms before and after using Goserelin and other questions regarding their experience with Goserelin. It is observed that the Symptom severity scale and the Health-related quality of life scale in all its 6 domains had an improvement in quality of live after the use of Goserelin. The UFS-QoL has 37 questions and there was an improvement in quality of life in all 37 questions. Most participants experienced hot flushes (78.2%). Amenorrhea was achieved in 82.9% of the participants. Fifteen (68.1%) participants experienced vaginal dryness. Therefore Goserelin is effective to improve quality of life of women with abnormal uterine bleeding due to leiomyomas, although, hot flushes and vaginal dryness are common adverse effects.
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Effect of goserelin in quality of life of women with abnormal uterine bleeding and leiomyoma: a case series DOI: https://doi.org/10.34119/bjhrv6n1-056Keywords: uterine bleeding, leiomyoma, goserelin, quality of lifeAbstract Leiomyomas are a major source of morbidity and decrease in quality of life for women of reproductive age. Goserelin is a Gonadotrophin-releasing hormone agonist (GnRHa) which treats leiomyomas inducing a hypogonadotropic state. Adverse effects includes hot flushes and vaginal dryness. When choosing a treatment, its capability to improve the patient’s quality of life must be taken in consideration. The objective of this retrospective case series was to study the impact of Goserelin in the quality of life of women with leiomyomas and abnormal uterine bleeding refractory to hormonal contraceptives. In this study, twenty-three women with abnormal uterine bleeding due to leiomyoma who were treated with Goserelin at two tertiary public teaching hospitals from Brazil answered the UFS-QoL regarding their leiomyoma symptoms before and after using Goserelin and other questions regarding their experience with Goserelin. It is observed that the Symptom severity scale and the Health-related quality of life scale in all its 6 domains had an improvement in quality of live after the use of Goserelin. The UFS-QoL has 37 questions and there was an improvement in quality of life in all 37 questions. Most participants experienced hot flushes (78.2%). Amenorrhea was achieved in 82.9% of the participants. Fifteen (68.1%) participants experienced vaginal dryness. Therefore Goserelin is effective to improve quality of life of women with abnormal uterine bleeding due to leiomyomas, although, hot flushes and vaginal dryness are common adverse effects. References OKOLO S. Incidence, aetiology and epidemiology of uterine fibroids. Best Practice & Research Clinical Obstetrics & Gynaecology, 2008, 22 (4): 571–588. KEMPSON RL and HENDRICKSON MR. Endometrial Stromal and Mixed Müllerian Tumors of the Uterus. Modern Pathology, 2000, 13 (3): 328–342. STEWART EA, et al. Uterine fibroids. Nature Reviews Disease Primers, 2016, 2 (1): 1-18. HODGSON R, et al. GnRH agonists for uterine fibroids. Cochrane Database of Systematic Reviews, 2017, 2017 (10). STEWART EA. Overview of treatment of uterine leiomyomas (fibroids). Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed on December 07th, 2022) LABEL. Zoladex. Available in: https://www.farmadelivery.com.br/media/upload/pdf/BULAS/ASTRAZENECA/Zoladex-e-Zoladex-Depot.pdf. Accessed in: December 07, 2022 KESSEL B, et al. Treatment of uterine fibroids with agonist analogs of gonadotropin-releasing hormone. Fertility and sterility, 1998, 49 (3): 538-541. SANGKOMKAMHANG US, et al. Progestogens or progestogen-releasing intrauterine systems for uterine fibroids (other than preoperative medical therapy). Cochrane Database of Systematic Reviews, 2020, (11). SOYSAL S, et al. The effects of post-surgical administration of goserelin plus anastrozole compared to goserelin alone in patients with severe endometriosis: a prospective randomized trial. Human Reproduction, 2004, 19 (1); 160-167. MILLER RM and FRANK RA. ZoladexR (goserelin) in the treatment of benign gynaecological disorders: an overview of safety and efficacy. BJOG: An International Journal of Obstetrics and Gynaecology, 1992, 99 (7): 37-41. SPIES JB, et al. The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata. Obstet. Gynecol, 2002, 99 (2): 290-300.

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