Effect of Goserelin Depot in Patients of Abnormal Uterine Bleeding

Background: Uterine fibroids (UFs), affecting up to 70% of reproductive-aged women, are common hormone-dependent tumors often associated with abnormal uterine bleeding (AUB), pelvic pain, and pressure.While 30% are incidentally diagnosed, many require intervention, with standard treatments including myomectomy or hysterectomy.For women desiring fertility preservation, non-surgical options are vital.Though gonadotropin-releasing hormone (GnRH) agonists like Goserelin have shown potential in fibroid reduction, limited data exist on their clinical efficacy.Aim of the study: To evaluate the effect of Goserelin depot in patients with AUB and assess clinical outcomes including symptom relief and fibroid response.Methodology: This observational study was conducted over 12 months at ESIC Medical College and PGIMSR, Bengaluru, involving 40 women aged 18-50 years presenting with AUB, and on Goserelin.Patients were selected based on clinical and ultrasonographic confirmation of AUB and on Goserelin depot 3.6 mg subcutaneously every 28 days for 3 months.Baseline and post-treatment evaluations included clinical assessment, uterine size measurement, symptom monitoring, and hemoglobin levels.Data were recorded using a structured proforma and analyzed using SPSS version 21.Results: In this study involving 40 women with AUB, 50% were under 40 years, and 47.5% were multiparous.The most common symptoms were dysmenorrhea (47.5%) and heavy menstrual bleeding (45%).Abnormal uterine bleeding-leiomyomas (AUB-L) was the leading diagnosis (40%), and 80% were managed conservatively.After three doses of Goserelin, 100% experienced symptom relief, with 85% showing normal ultrasound and 15% showing uterine size reduction.Mean hemoglobin significantly improved from 9.55 1.22 to 10.70 0.94 gm/dL (p < 0.001).Uterine size reduction was more common in nulliparous women (p = 0.027), supporting Goserelin's efficacy in conservative AUB management.Conclusion: Goserelin depot effectively alleviated symptoms in all AUB patients, significantly improved hemoglobin levels, and reduced uterine size in select cases, particularly among nulliparous women and those managed conservatively.With most patients avoiding surgery, the study confirms Goserelin's clinical utility as a non-surgical therapeutic option in AUB, aligning with the objective of evaluating its impact on symptom relief and treatment outcomes.