Use and Effectiveness of Gonadotropin-Releasing Hormone Agonists for Prophylactic Menstrual Suppression in Postmenarchal Women Who Undergo Hematopoietic Cell Transplantation.

Abstract

STUDY OBJECTIVE:

To describe the rates of use and effectiveness of gonadotropin-releasing hormone (GnRH) agonists and other forms of hormonal menstrual suppression in prevention of vaginal bleeding among young women who underwent hematopoietic stem cell transplantation (HCT).

DESIGN:

Retrospective descriptive study.

SETTING:

University-based pediatric HCT practice.

PARTICIPANTS:

Fifty-five postmenarchal women who underwent HCT between 2004 and 2011.

INTERVENTIONS:

Administration of GnRH agonists or other forms of hormonal menstrual suppression.

MAIN OUTCOME MEASURES:

Rates of use of GnRH agonists and other forms of hormonal menstrual suppression, and rates and descriptions of vaginal bleeding.

RESULTS:

Forty-six of the 55 patients had experienced regular or irregular vaginal bleeding before HCT and were considered to be at risk for thrombocytopenia-associated menorrhagia. Forty of the 46 (87%) received hormonal menstrual suppression. Thirty-three patients were treated with a GnRH agonist, 4 with combined hormonal contraceptive pills, 1 with a combined hormonal contraceptive patch, 1 with depot medroxyprogesterone, and 1 with oral norethindrone. Twenty-nine of the 33 patients (88%) who received a GnRH agonist had complete amenorrhea during HCT and 4 of 33 (12%) experienced some degree of vaginal bleeding.

CONCLUSION:

GnRH agonists appear effective in prevention of vaginal bleeding complications in most postmenarchal women who underwent HCT. Some patients who might benefit do not receive a GnRH agonist and multiple barriers exist in identification and treatment of them.

• Authors: Philip D Poorvu, Sara E Barton, Christine N Duncan, Wendy B London, Marc R Laufer, Leslie E Lehmann, Karen J Marcus
• Journal: Journal of pediatric and adolescent gynecology (J Pediatr Adolesc Gynecol) Vol. 29 Issue 3 Pg. 265-8 (Jun 2016) ISSN: 1873-4332 [Electronic] United States
• PMID: 26506031 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Contraceptive Agents, Female
• Goserelin
• Gonadotropin-Releasing Hormone
• Leuprolide

Topics

• Adolescent
• Adult
• Amenorrhea (chemically induced)
• Child
• Contraceptive Agents, Female (administration & dosage)
• Female
• Gonadotropin-Releasing Hormone (agonists)
• Goserelin (administration & dosage)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Leuprolide (administration & dosage)
• Preoperative Care (methods)
• Retrospective Studies
• Treatment Outcome
• Uterine Hemorrhage (etiology, prevention & control)
• Young Adult