Evaluation of Single-Dose Oral Cetrorelix versus Depository Leuprolide Acetate for the Medical Management of Symptomatic Uterine Leiomyomas

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 337–348

DOI: 10.46882/2026/IJOG/000505

Original Research Article

Title: Evaluation of Single-Dose Oral Cetrorelix versus Depository Leuprolide Acetate for the Medical Management of Symptomatic Uterine Leiomyomas

Names of Authors: Mariam T. Bello¹, Grace E. Effiong²

Authors’ Affiliations:
¹ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University College Hospital, Ibadan, Nigeria
² Department of Public Health, University of Calabar, Calabar, Nigeria

Abstract:
Injectable gonadotropin-releasing hormone (GnRH) agonists are widely used to reduce fibroid volume but trigger initial hormonal flare-ups and severe hypoestrogenic side effects. This randomized active-controlled study evaluated the clinical efficacy, fibroid volume reduction, and safety of an oral, non-peptide GnRH antagonist, cetrorelix, compared to monthly intramuscular leuprolide acetate deposits. One hundred and forty premenopausal women presenting with heavy menstrual bleeding due to uterine leiomyomas were randomized into two equal groups (n = 70 per group) for a treatment duration of 12 weeks. The primary endpoints were the percentage reduction in total fibroid volume and the control of menorrhagia. At week 12, the mean reduction in the volume of the dominant fibroid was 44.5% ± 8.4% in the oral cetrorelix group and 48.2% ± 9.1% in the leuprolide acetate cohort, demonstrating therapeutic equivalence (p = 0.12). Menorrhagia scores improved substantially in both groups within 4 weeks (p < 0.001). However, the oral cetrorelix cohort reported a significantly faster onset of symptom relief due to the immediate avoidance of a flare effect (p = 0.004). Furthermore, mean bone mineral density drops were significantly less pronounced in the cetrorelix arm (-0.4% vs. -1.8%, p = 0.008), and vasomotor symptom scores (hot flashes) were less severe. Daily oral cetrorelix serves as an efficient non-invasive therapeutic option for symptomatic uterine fibroids, providing swift volume reduction and menorrhagia resolution with an improved safety profile compared to long-acting GnRH agonists.

Keywords: Uterine Leiomyoma; GnRH Antagonist; Cetrorelix; Leuprolide Acetate; Fibroid Volume; Menorrhagia.

Manuscript Timeline: Received: May 20, 2026; Revised: July 10, 2026; Accepted: August 01, 2026; Published: August 12, 2026.

Citation: Bello MT, Effiong GE. Evaluation of Single-Dose Oral Cetrorelix versus Depository Leuprolide Acetate for the Medical Management of Symptomatic Uterine Leiomyomas. International Journal of Obstetrics and Gynecology. 2026; 14(8): 337–348.

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