goserelin and Anemia--Hypochromic

Menorrhagia is the most frequent symptom in women with leiomyomata uteri. We induced transient hypoestrogenism with a gonadotropin-releasing hormone agonist, goserelin (Zoladex, I.C.I.), in a depot formulation, to resolve severe anemia in 16 women with uterine myomas. Subcutaneous administration of goserelin 3.6 mg was repeated every 28 days for 6 months. Thirteen patients became amenorrheic in 5 weeks and 3 reported scanty bleeding. Estradiol fell to postmenopausal levels after one month's treatment with hormonal surges on only three occasions. Uterine volume decreased by 49% after 3 months' treatment but subsequent reduction was not achieved. Mean hemoglobin rose from 7.4 g/dl pretreatment to 13.2 g/dl at 3 months (+78.3%) and mean hematocrit from 26.1% to 39.8% (+52.4%) without any further improvement. Serum ferritin increased constantly during the 6 months. Goserelin depot therapy in severely anemic patients with leiomyomas and menorrhagia is practical, safe and may avoid the need for preoperative transfusion.

Topics: Adult; Anemia, Hypochromic; Buserelin; Delayed-Action Preparations; Female; Goserelin; Humans; Leiomyoma; Menorrhagia; Middle Aged; Uterine Neoplasms

To investigate the effect of gonadotropin releasing hormone agonist (goserelin) treatment before hysterectomy for leiomyomata-associated menorrhagia.. Prospective, comparative, nonrandomized study.. A teaching hospital of Milano University.. Anemic women requiring hysterectomy for myoma-associated menorrhagia.. Six months' preoperative goserelin treatment (41 cases) or immediate surgery (92 controls).. Abdominal/vaginal hysterectomy rate, number of transfusions, operating time, blood loss, complications, febrile morbidity, and days in hospital.. In the goserelin group mean hemoglobin rose (8.5 versus 13.3 g/dl) and mean uterine volume decreased (528 versus 251 ml). At preoperative pelvic exploration abdominal hysterectomy was indicated in 22 (54%) cases and 74 (80%) controls and vaginal hysterectomy in 19 (46%) and 18 (20%) (relative risk 3.6, 95% confidence interval 1.6 to 7.7; p = 0.001). No case required a transfusion whereas 51% of controls needed a total of 127 packed red cell units.. In anemic women with menorrhagia and leiomyomas, gonadotropin releasing hormone agonist treatment before hysterectomy limited transfusion requirements and increased the vaginal procedure rate.

Topics: Adult; Anemia, Hypochromic; Female; Goserelin; Humans; Hysterectomy; Leiomyoma; Menorrhagia; Middle Aged; Premedication; Prospective Studies; Treatment Outcome; Uterine Neoplasms

Twenty-three women with chronic heavy anovulatory uterine bleeding and severe iron-deficiency anemia received six months' treatment with goserelin, a gonadotropin releasing hormone agonist, administered as a monthly subcutaneous depot. After two months of treatment, all patients were amenorrheic and subsequent spotting was reported on only nine occasions. Laboratory results showed the following values: mean hemoglobin before treatment, 7.9 g/dL-13.8 g/dL at six months (+75%); mean hematocrit, 26.3%-41.6% (+58); mean serum iron, 19.8 micrograms/dL-63.3 micrograms/dL (+134%) and mean serum ferritin, 6.2 ng/mL-35.3 ng/mL (+469%). The endometrial hyperplasia observed in 11 subjects showed regression at follow-up suction biopsy. Gonadotropin releasing hormone agonists administered in a depot formulation for a few months in highly selected patients with severe anemia associated with heavy anovulatory uterine bleeding are practical, safe and effective, may avoid blood transfusions and could be used as a first line of treatment.

Topics: Adult; Anemia, Hypochromic; Anovulation; Delayed-Action Preparations; Female; Goserelin; Humans; Menorrhagia; Middle Aged