GnRH agonists and antagonists in therapy of symptomatic uterine fibroids – current roles and future perspectives

Introduction Uterine fibroids are the most common noncancerous tumors in women of childbearing age. This review was developed to evaluate the current role of gonadotropin-releasing hormone (GnRH) agonists and antagonists in therapy of symptomatic uterine fibroids.Areas covered There is a great need of alternative methods to surgical treatment of uterine fibroids. The hormonal therapy remains the first line treatment option for most patients. GnRH analogs (agonists and antagonists) modulate the pulsatile release of GnRH. This review summarizes the available literature concerning pharmacologic principles underlying the mechanism of action of GnRH and its analogs, as well as individual therapeutic applications to which these drugs have been applied.Expert opinion In many cases it is possible to try to treat uterine fibroids pharmacologically. Both groups of GnRH analogs are used in therapy, agonists instead as a preparation for surgery, and antagonists as a drug for long-term use. It is essential to develop this path further and look for at least long-term release systems or new methods of administering these drugs. It is also important from the patient's perspective to search for possible drugs that may give an additive effect of decreasing side effects when combined with GnRH analogs.