Gonadotropin-releasing hormone agonists: strategies for managing the hypoestrogenic effects of therapy.

Gonadotropin-releasing hormone agonists have been shown to be comparable with danazol for the treatment of endometriosis. These results are important because danazol is associated with a significant number of side effects, particularly androgenic effects, such as weight gain and acne. 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. These findings suggest that such regimens may further enhance the clinical usefulness of gonadotropin-releasing hormone agonist therapy for endometriosis and other estrogen-mediated diseases.