Possible Interaction: Gonadotropin-Releasing Hormone and Progestins

“ Progestogens should be used before LHRH agonists or estrogens.”

“These binding sites mediate the inhibitory effects of GnRH and its agonists on gonadotropin-stimulated estrogen, progestin and androgen biosynthesis.”

“Evidence on harms was scanty, but GnRH analogues, danazol and depot progestagens were associated with higher rates than other interventions.”

“Several clinical trials demonstrate that progestins inhibit and/or reverse the ability of hypoestrogenism induced by a gonadotropin-releasing hormone agonist to shrink uterine myomas, suggesting a critical role for progesterone in growth of myomas.”

“Bone loss with gonadotropin-releasing hormone agonists could be prevented or attenuated with progestins , and this is worthy of further studies.”

“Although gonadotropin-releasing hormone agonists are associated with hypoestrogenic side effects, such as hot flashes and reversible bone density loss, recent studies suggest that the risk of these side effects may be modified when gonadotropin-releasing hormone agonists are combined with a progestin.”

“Nevertheless, a short-term study of patients with endometriosis showed that adding small amounts of progestin during treatment with a gonadotropin-releasing hormone agonist may help prevent bone changes.”

“In conclusion, intermittent administration of appropriate LH-RH agonist dosing in combination with a progestogen would effectively block ovulation while preserving adequate cyclic estradiol secretion and could be an alternative contraceptive approach.”

“It was found that the EE-induced augmentation of pituitary responsiveness to GnRH is diminished by the addition of progestins.”

“Conversely, concurrent progestin stimulation potentiated the E2-induced augmentation of tissue concentrations of GnRH receptor.”

“These data indicate that prolonged progestin stimulation leads to a decrease in tissue concentrations of GnRH receptor and GnRH receptor mRNA.”