leuprolide acetate (depot) + estrogen

Leuprolide acetate (depot) + estrogen is a combination regimen used primarily in the management of endometriosis. Leuprolide acetate is a gonadotropin-releasing hormone (GnRH) agonist administered as a long-acting depot injection. It works by initially stimulating and then downregulating pituitary GnRH receptors, leading to decreased secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which results in suppression of ovarian sex steroid production—primarily estradiol—in women. This hypoestrogenic state reduces endometriotic lesions and associated pain but can cause significant side effects such as bone mineral density loss and vasomotor symptoms. To mitigate these adverse effects, "add-back" therapy with low-dose estrogens (often conjugated equine estrogens or estradiol) may be combined with leuprolide acetate. The addition of estrogen helps preserve bone density and reduce vasomotor symptoms without significantly diminishing the efficacy of endometriosis symptom control[4]. This combination is not an FDA-approved fixed product but represents an established clinical practice for extended use beyond 6 months when monotherapy would otherwise be limited due to safety concerns.

Other names

Depot Lupron + estrogenleuprolide acetate depot + estrogenGnRH agonist add-back therapy with estrogen