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GnRH agonists and antagonists in therapy of symptomatic uterine fibroids - current roles and future perspectives

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TAYLOR & FRANCIS LTD
DOI: 10.1080/14656566.2023.2248890

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Uterine fibroid; leiomyoma; pharmacotherapy; GnRH analong; GnRH agonist; GnRH antagonist

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Uterine fibroids are commonly seen in women of childbearing age. Hormonal therapy, particularly the use of GnRH analogs, is widely used for treatment. Further research and development of new release systems or methods of administration, as well as the search for drugs that can decrease side effects when combined with GnRH analogs, is crucial.
IntroductionUterine fibroids are the most common noncancerous tumors in women of childbearing age. This review was developed to evaluate the current role of gonadotropin-releasing hormone (GnRH) agonists and antagonists in the therapy of symptomatic uterine fibroids.Areas coveredThere is a great need for alternative methods for surgical treatment of uterine fibroids. Hormonal therapy remains the first-line treatment option for most patients. GnRH analogs (agonists and antagonists) modulate the pulsatile release of GnRH. This review summarizes the available literature concerning pharmacologic principles underlying the mechanism of action of GnRH and its analogs, as well as individual therapeutic applications to which these drugs have been applied.Expert opinionIn many cases, it is possible to try to treat uterine fibroids pharmacologically. Both groups of GnRH analogs are used in therapy, agonists instead as a preparation for surgery, and antagonists as a drug for long-term use. It is essential to develop this path further and look for at least long-term-release systems or new methods of administering these drugs. It is also important from the patient's perspective to search for possible drugs that may have an additive effect of decreasing side effects when combined with GnRH analogs.

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