Gonadotropin-releasing hormone agonists and uterine fibroids: a look into the past or a reliable future?
The article analyzes the role of gonadotropin-releasing hormone agonists (aGn-RG) in the treatment of patients with uterine fibroids, which remain highly prevalent and have a significant impact on women’s reproductive health. Modern concepts of the pathogenesis of uterine fibroids are considered, including the role of hormonal imbalance, angiogenesis, inflammatory mediators and immunological factors. The paper provides an overview of surgical and medical treatment methods, including organ-preserving operations, uterine artery embolization, and the use of hormonal drugs. The mechanism of action of aGn-RG is considered in detail, based on induced hypoestrogenism and suppression of the function of the pituitary-ovarian axis, which leads to a decrease in the size of myoma nodes, a decrease in the severity of inflammatory processes and a decrease in symptoms. The data from meta-analyses and clinical studies confirming the effectiveness of aGn-RG in preoperative preparation, reduction of blood loss and improvement of postoperative outcomes are presented, and at the same time the limitations of the method are discussed. It is concluded that aGn-RG, including buserelin, employ an important place in the multimodal and personalized treatment of patients with uterine fibroids and endometriosis, but require balanced and differentiated use.