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.