Hodgen G D
Jones Institute for Reproductive Medicine, Norfolk, Virginia.
Curr Opin Obstet Gynecol. 1991 Jun;3(3):352-7.
GnRH agonist (GnRHa) medications are now routinely used by gynecologists, urologists, medical endocrinologists, and pediatric endocrinologists alike. GnRHa are frequently highly effective in diminishing pain derived from endometriotic lesions. Current US Food and Drug Administration approval limits GnRHa regimens to a 6-month course largely because of concern that the hypoestrogenic state invoked by the medication can lead to loss of bone mineral density. Most studies on this issue show either a very small diminution of bone density over this interval or no detectable changes. The role of GnRHa in shrinking uterine fibroids and/or diminishing bleeding, both before and during surgery is much more an adjunctive-to-definitive surgical intervention than a free-standing medical therapy. Attempts to suppress with GnRHa and co-administer estrogens with progestins or progestins alone, either concurrently or sequentially (delayed), are now being studied vigorously. The place of GnRHa in medical management of a variety of endocrine conditions is no the standard of care.
促性腺激素释放激素激动剂（GnRHa）药物如今被妇科医生、泌尿科医生、医学内分泌学家和儿科内分泌学家广泛应用。GnRHa在减轻子宫内膜异位症病灶引起的疼痛方面通常非常有效。美国食品药品监督管理局目前批准的GnRHa治疗方案限制在6个月疗程，主要是因为担心该药物引发的低雌激素状态会导致骨矿物质密度流失。关于这个问题的大多数研究表明，在此期间骨密度要么仅有非常小的降低，要么没有可检测到的变化。GnRHa在手术前和手术期间缩小子宫肌瘤和/或减少出血方面的作用，更多的是作为确定性手术干预的辅助手段，而非独立的药物治疗。目前正在大力研究同时或序贯（延迟）使用GnRHa抑制，并联合使用雌激素与孕激素或单独使用孕激素的方法。GnRHa在各种内分泌疾病的药物治疗中的地位并非治疗标准。
