Uterine ultrasonographic changes with gonadotropin-releasing hormone agonists

OBJECTIVES: Our purpose was to assess the changes in uterine Volume and ute rine artery pulsatility index in response to gonadotrapin-releasing hormone agonist treatment in women undergoing hysterectomy for nonfibroid-related uterine bleeding. STUDY DESIGN: A double-blind, placebo-controlled randomized trial of 51 wom en awaiting hysterectomy in a gynecology outpatient clinic was conducted. T he women were treated for 8 weeks with either leuprolide acetate depot or p lacebo. Vaginal ultrasonographic examinations were performed before and aft er treatment. The paired t test was used for statistical analysis. RESULTS: In those allocated to therapy with gonadotropin-releasing hormone agonist the mean uterine Volume decreased by 34% and the uterine artery pul satility index increased from 2.25 to 2.7. No significant changes were seen in the placebo group. The intersonographer variability was low and there w as a high correlation between uterine size as measured by ultrasonography b efore hysterectomy and that measured postoperatively. CONCLUSIONS: Treatment with gonadotropin-releasing hormone agonists leads t o uterine shrinkage and an increase in the uterine artery pulsatility index even in the absence of uterine fibroids.