Detailed definition
Leuprolide is a synthetic decapeptide GnRH agonist available as monthly or three-monthly depot injections (Lupron Depot, Eligard) and as a daily subcutaneous formulation. Continuous (rather than pulsatile) GnRH receptor stimulation paradoxically downregulates pituitary GnRH receptors, leading to suppression of FSH and LH and consequent ovarian quiescence. The result is a profound estrogen-deprived state similar to menopause, used clinically for endometriosis, uterine fibroids, hormone-sensitive breast or prostate cancer, central precocious puberty, and as part of fertility cycles. Symptoms during leuprolide therapy mirror surgical or natural menopause. "Add-back" therapy with low-dose estrogen and progestin can mitigate symptoms during long-term use without compromising efficacy for the underlying condition.
Why it matters in menopause
Women on leuprolide for benign disease (endometriosis, fibroids) often experience severe vasomotor and sleep symptoms. Add-back HRT with carefully chosen low-dose estrogen-progestogen can substantially improve quality of life without compromising the leuprolide indication.
Related terms
Sources
External references: Wikipedia.