Effectiveness

Ineffective 24 weeks after drug ceases fibroids return to original size [19] 

Yes

Only temporary,
re-growth of fibroids & adhesions -likely to need a  hysterectomy
[8],[21],[23],[24],[25]

93-97%
[29],[30],[60],[65]

Fibroid re-growth

Yes returns to normal after 24 weeks [19] 

No

Yes requiring surgery in 51% of cases for re-growth
[23] 

Unlikely
(1%)
[29],[30],[60], [65] 
Side Effects Hot flushes &menopausal symptoms, memory loss, bone loss, insomnia, osteoporosis, vaginitis
[5],[20]   		Menopause 5 years earlier, clinical depression,  cardiovascular incidents more likely
[10],[11],[12]  		Pain, pelvic adhesions and re-growth of fibroid
[4],[21],[22],[23]  		Flu-like symptoms, expulsion or removal of  fibroids (5-7%), discharge (1-20%) which resolves spontaneously  or following hysteroscopy
[29],[30],[31],[60], [64],[65],[68] 

Fertility post-op

Infertile while on treatment

Infertile

Maintain fertility

Maintain fertility

1-7% developed amenorrhoea 
[65],[68] 

Pregnancy post procedure

Unlikely while being treated

No, infertile

Yes,27-67%
[21],[22] 

 Yes
There have been at least 50 successful pregnancies to date
Ability to have HRT if desired/
required 		No - will counteract effects of drug, fibroids will re-grow Yes, required especially if ovaries removed, may need it sooner as menopause earlier

Not affected

but usually leads to hysterectomy

 Not affected
Psychological effect Mood swings and possible depression [5],[20]  Loss of femininity, possible clinical depression  [12],[17]  None reported No adverse effects reported

Other complications

Very unpleasant side effects in most
[5],[19],[20] 

Overall short-term complications - 9-16%  [13],[15],  >50% had worse symptoms [14] 

Surgical complication rate increases to 61.7% with very large fibroids [70] 

Longer term disease -
depression,

urinary incontinence 14-17% [72] increases odds by 30%   [73] 

sexual dysfunction
 

1.8-25%

Adhesions 55-100%
[21],[23],[24],[25] 

No permanent injuries or disease 

Complications 5% [68] 

Mortality

Unknown

1 in 3,300 to 1-2 in 1,000 [15]

41 deaths p.a. for all non-malignant gynae surgery ('96/7) [26]

41 deaths p.a. for all non-malignant gynae surgery ('96/7) [26] 

Approx. 1 in 12,500

Last updated: 12 Apr 2004

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