If you’ve been diagnosed with endometriosis, there’s a good chance your doctor has offered you a drug that inhibits gonadotrophin releasing hormone (GnRH).
The one most commonly prescribed in the United States is a drug called Lupron. Other ones I’ve heard named are Zoladex and Synarel.
Before you move forward with the decision to put one of these GnRH antagonist drugs into your body, it’s good to be aware of how they work, and the longer term impacts they could have on you.
GnRH’s role in your body
This hormone, GnRH, is synthesized and released from GnRH neurons in your brain. These neurons have connections to the part of your brain known as the limbic system, which is heavily involved in the control of your emotions, memory and sexual activity.
GnRH is responsible for the release of follicle stimulating hormone (FSH) and lutienizing hormone (LH), from your pituitary gland, which triggers ovulation in your body.
Studies have found GnRH receptors throughout the body, so it’s not only associated with your reproductive axis. It affects your central nervous system and many other vital processes in your body.
GnRH has been shown to have cardiovascular roles and receptor production in your endometrium, ovaries, adrenal glands, lymphocytes, kidney, liver and bladder.
Additionally, studies show that GnRH may play a role in the regulation of both dopamine and GABA. These two neurotransmitters play a key role in the regulation of your mood and energy levels.
How do GnRH antagonists work?
GnRH antagonists, like Lupron, compete with natural GnRH receptors in your pituitary gland and decrease or block GnRH action in your body.
As a result, this blocks the release of LH and FSH, which control the levels of hormones produced by your ovaries: testosterone, estradiol & progesterone. They’re also what stimulates ovulation. Without these hormones, your body will not ovulate. Without ovulation, you won’t have a period.
With the use of GnRH antagonists, there’s a resulting rapid reduction of sex hormone levels in your body.
Without LH, the release of estrogen from your ovaries is suppressed. So, essentially, your body’s kicked into a dramatic menopausal state.
Side effects of GnRH antagonists
There are different doses of these GnRH antagonists. They may be offered in three month, monthly or even daily injections. There are also nasal sprays, so you can get it right up in your brain. Yikes.
I’ve heard many horror stories from ladies who’ve taken GnRH antagonists. For many, the side effects are serious and long lasting.
One endo sister reached out to me a couple of days ago telling me that the impacts of Lupron were worse than the symptoms of endo! Her entire body was aching.
Some side effects of GnRH antagonists include:
- decreased libido
- mood swings
- vaginal dryness
- hot flashes
- weight gain
- muscle pains
- bone density loss, cracking bones
From what I’ve heard from other ladies who’ve gone this route, add-back therapy can help reduce some of the side effects.
With add-back therapy your doctor will prescribe a low dose of synthetic estrogen and/or progesterone to be taken along with the GnRH antagonist.
How effective are GnRH antagonists for endometriosis?
The ultimate purpose of these GnRH antagonists is to stop estrogen production, which has been shown to feed endometriosis.
While these drugs stop the communication with your ovaries, they don’t necessarily address the endometrial implants, which have been shown to produce their own levels of estrogen, thus promoting its own growth.
Also, endometriosis can create adhesions (areas of scar tissue) that can attach and pull on organs, nerves and other internal structures. Much of the pain from endometriosis is caused by this scar tissue. Adhesions are not affected by decreasing estrogen levels.
Short term vs. long term impacts
I understand the pulling desire to want to end the pain, but please understand that going this route is risky and will most definitely come with long term effects.
I dislike how easily these drugs are offered to women with endometriosis as a starting option, or as a way to “give your body a break”.
The discovery of diverse, widespread GnRH receptors throughout your body, begs for attention. GnRH may be a major modulator of multiple physiological systems in your body, not just reproduction.
So I urge you not to just jump in because this was offered as a solution. While it may provide short term relief for a few months, what are the longer term consequences?
On the Positive Side?
There are alternative ways to feel better with endometriosis. Please know this. It’s not hopeless.
If you need help, I do offer one on one health coaching services. I’d love to chat with you. Find out more and schedule time with me here.
Have you tried a GnRH antagonist? What was your experience?
I’d love to hear from you in the comments below.