Perimenopausal hot flashes do not depend on crude circulating oestradiol levels: further evidences from women treated with oral GnRH antagonists combination therapy for symptomatic fibroids.

PURPOSE Some perimenopausal women treated for fibroid-related bleeding may already experience hot flashes.

MATERIALS AND METHODS In this pilot case series, we evaluated the effect of relugolix combination therapy (relugolix 40 mg + oestradiol 1 mg + norethisterone acetate 0.5 mg) on hot flashes and endocrine parameters in seven perimenopausal women.

RESULTS All women reported a marked improvement (visual analogue scale: 8.6 ± 1.0) of hot flashes, while treatment significantly suppressed FSH (p = 0.004), LH (p = 0.002) and oestradiol (p = 0.002) serum levels.

CONCLUSIONS These preliminary findings indicate that hot flashes improvement may not depend on crude circulating oestradiol levels in perimenopausal women, but probably on their stabilisation with the oral GnRH antagonist addition.