Sustained Gonadal Suppression in Fertile Women With the LHRH Agonist Buserelin

Abstract

Nine fertile women were treated with the luteinizing- hormone-releasing hormone agonist buserelin (seven women received 800 micrograms, two women 1200 micrograms intranasally for up to 24 weeks). Both doses produced sustained suppression of ovarian function, accompanied by hot flushes. In five women chemical castration was established within 1 to 5 weeks, whereas in the other four volunteers transient peaks of serum oestradiol occurred between the 6th and 19th weeks. Thereafter low postmenopausal oestradiol levels persisted. Chemical castration was confirmed by hormonal parameters and endometrial biopsies (inactive endometrium). After cessation of treatment normal cyclical function occurred immediately. This reversible chemical castration may be useful for new therapeutical approaches in sexual hormone dependent diseases (endometriosis, precocious puberty, metastatic breast cancer).

Clinical aspects of LHRH analogues in gynaecology: a review

“…Ovulation either did not occur (Hardt & Schmidt-Gollwitzer 1983;Kuhl et al 1984) or was rare occurring in 3 of 628 treatment cycles and attributed to early technical problems with the nasal spray application (Bergquist. et al 1984).…”

“…Note that the efficacy of intranasal LHRH agonist contraception is dose-related. Amenorrhoea occurred in 25% of women on therapy, more particularly on higher doses (Hardt & Schmidt-Gollwitzer 1983). By contrast, doses of 100 yg LHRH agonist daily intranasally allowed 31 of 48 cycles to be ovulatory and one subject conceived (Schmidt-Gollwitzer et a/.…”

Clinical applications of gonadotrophin-releasing hormone and its analogues

“…Meldrum et al (1982) have reported the first successful treatment with daily administration of a 100-^g dose of a GnRH agonist, oestrogen and androgen levels being reduced to castration levels in one month. After the cessation of a sustained gonadal suppression with the agonist (buserelin), normal cyclical function in fertile women occurred immediately (Hardt and Schmidt-Gollwitzer, 1983). The treatment was well tolerated in spite of the expected hot flushes and vaginal dryness (Lemay et al, 1984).…”

Failure of buserelin-induced medical castration to control pulmonary lymphangiomyomatosis in two patients

“…18 Buserelin was chosen from among other synthetic LHRH-As because of its potent and specific LHRH activity and its strong ability to cause a reversible medical castration. 15 Luteinizing hormone releasing hormone is a hypothalamic decapeptide which is carried through the pituitary portal system from the eminentia mediana to the anterior pituitary gland. It binds specifically to high affinity receptors on the pituitary gonadotrophic cells and stimulates the synthesis and release of gonadotrophins (LH and FSH).…”