A 35-year-old woman with confirmed stage III endometriosis desires pain relief and fertility preservation. She has failed NSAIDs and combined oral contraceptives. Which medical therapy acts by creating a hypoestrogenic state through receptor downregulation at the pituitary level?
- A Leuprolide acetate ✓
- B Dienogest
- C Medroxyprogesterone acetate
- D Danazol
Correct answer: A. Leuprolide acetate
Explanation
GnRH agonists (leuprolide) initially stimulate then downregulate pituitary GnRH receptors, causing profound suppression of gonadotropin release and a medical castration state. Danazol is an androgen derivative that suppresses the mid-cycle LH surge through multiple mechanisms but does not primarily act via pituitary receptor downregulation. Progestins and dienogest act directly on endometrium.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.