Objective: To review the impact of gonadotropin-releasing hormone agonists (GnRH-as) on bone mass in adolescents and options for GnRH-a with "add-back" for long-term therapy for adolescents with endometriosis not responding to conventional therapy.
Study design: Literature research.
Results: The use of GnRH-a plus add-back therapy has not been specifically studied in the adolescent population, and thus the ideal dosage of add-back sex steroids for adolescents has not been delineated.
Conclusion: GnRH-a plus add-back can be considered for usage in adolescents with endometriosis who are refractory to conventional therapy, but steroids are needed to determine the ideal dosage and long-term effects.