Goserelin
A GnRH-agonist decapeptide delivered as a subcutaneous biodegradable implant. Licensed for prostate and hormone-receptor-positive breast cancer, endometriosis and endometrial thinning, working — like leuprolide — by suppressing gonadotropins and sex-steroid production after an initial flare.
01 Overview
Goserelin is a synthetic analogue of GnRH formulated as a small cylindrical depot implanted subcutaneously (usually into the abdominal wall) that releases drug over one or three months. Continuous receptor occupation desensitises the pituitary, cutting LH/FSH and driving testosterone or oestradiol to very low levels.
It has a long, well-documented clinical record in oncology and gynaecology. Its therapeutic effects and adverse profile mirror the GnRH-agonist class: reliable hormone suppression with menopausal/andropausal side effects and, with extended use, bone loss.
02 Mechanism
Sustained GnRH-receptor agonism causes pituitary desensitisation and suppression of LH/FSH, lowering gonadal sex-steroid production after an initial surge.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Monthly implant | 3.6 mg | SubQ | 3.6 mg depot every 28 days. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Sex-hormone suppressionLowers testosterone or oestradiol to slow hormone-sensitive cancers and endometriosis. | Castrate/menopausal levels | Clinical | |
| Endometrial thinningUsed pre-operatively to thin the endometrium before surgery. | Reduced endometrial thickness | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Menopausal/andropausal symptomsHot flushes, sweats, libido loss and mood change from hormone withdrawal. | Moderate | Nearly universal | Clinical | |
| Bone density lossProlonged low-oestrogen/testosterone state reduces bone mineral density. | Moderate | Common with prolonged use | Clinical | |
| Injection-site reactionLocal bruising, pain or rare haematoma at the implant site. | Mild | Common | Clinical |