Utilization of Gonadotropin-Releasing Hormone Antagonist in Uterine Adenomyosis Particularly on Association with Fibroids & Infertility – Offers Some Hope for Saving Uterus & Future Fertility – A Short Communication
Kulvinder Kochar Kaur¹*, Gautam Allahbadia² and Mandeep Singh³
¹Scientific Director, Dr. Kulvinder Kaur Centre for Human Reproduction, India
²Scientific Director, Ex-Rotunda-A Centre for Human Reproduction, India
³Consultant Neurologist, Swami Satyanand Hospital, India
*Corresponding Author: Kulvinder Kochar Kaur, Scientific Director, Dr Kulvinder Kaur Centre For Human Reproduction, 721, G.T.B. Nagar, Jalandhar-144001, Punjab, India
DOI: 10.64258/3070-9792.2025.104003
Submission Date: October 3, 2025
Published Date: October 25, 2025
Download PDFEarlier, we reviewed the detailed etiopathogenesis and treatment of uterine adenomyosis, including its origin. Additionally, we described the mechanistic modes by which GnRH analogues act on adenomyosis. Various hormonal and non-hormonal therapies have been prescribed for symptomatic relief, including nonsteroidal anti-inflammatory drugs, combined estrogen–progestin contraceptives, and both systemic and intrauterine progestins, such as the 52 mg levonorgestrel-releasing intrauterine device, along with gonadotropin-releasing hormone (GnRH) agonists and antagonists.
Despite these options, all GnRH analogues, including elagolix at a dose of 300 mg twice daily with add-back therapy (1 mg estradiol/0.5 mg norethindrone acetate once daily), have demonstrated significant reduction in heavy menstrual bleeding (HMB) in women with uterine fibroids and concurrent adenomyosis, indicating that the efficacy of elagolix is not adversely affected by the presence of adenomyosis. However, rapid recurrence of symptoms is typically observed following cessation of therapy.
Findings from previous studies have further demonstrated that linzagolix, administered at a higher dose for 12 weeks followed by a lower maintenance dose for an additional 12 weeks, represents a viable alternative for managing adenomyosis-associated symptoms. Nevertheless, the rapid return to baseline uterine volume and bleeding patterns suggests that modified regimens are necessary for long-term management.
Recent studies on relugolix combination therapy—comprising 40 mg relugolix, 1 mg estradiol, and 0.5 mg norethindrone acetate as a once-daily single-tablet regimen—have been explored through different approaches, offering potential hope for sustained regression of uterine adenomyosis, particularly in patients with infertility.
Uterine Adenomyosis; GnRH analogues; Elagolix twice daily with add-back; 40 mg of Relugolix; Linzagolix
Kulvinder KK, Gautam A, Mandeep S (2025) Utilization of Gonadotropin-Releasing Hormone Antagonist in Uterine Adenomyosis Particularly on Association with Fibroids & Infertility - Offers Some Hope for Saving Uterus & Future Fertility - A Short Communication. Gynecol & Women’s Health: Open Access 1(1): 1-13