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Decapeptyl

Date issued:  November 2022

For review: November 2024

Ref: B-470/RMR/Gynae/Decapeptyl v2

PDF: Decapeptyl [pdf] 492KB

What is Decapeptyl?

Decapeptyl belongs to a group of medicines called Gonadotrophin Releasing Hormone Agonists (GnRHa).

These drugs are used to “switch off” your ovaries and put you into a temporary menopausal state.

Other drugs you may come across in this group are Zoladex or Prostap.

What is it used for?

  • To suppress or reduce symptoms of endometriosis and adenomyosis

  • Prior to surgery for endometriosis, to shrink disease and reduce inflammation in order to make surgery easier and safer

  • To control problematic vaginal bleeding

  • To shrink fibroids

  • To help address pre-menstrual syndrome

  • In some fertility treatment regimes

  • As a way to help guide patients with pelvic pain, especially if surgery is to be considered when a diagnosis has not been reached. For some women this response may help them decide if they want to have their ovaries removed.

How is it given?

Decapeptyl is given by injection into the buttock area. The first dose is often given in gynaecology clinic by our nurses, after that you can have it from your GP practice nurse. You should begin your treatment on the first 2–4 days of your period to minimise the likelihood of taking the drug while pregnant. If there is any possibility that you may be pregnant, you should not begin treatment.

It comes in 2 different doses; a 1 month preparation or a 3 month preparation. Initially we will start you on monthly injections, if you are going to continue on it for longer we can then switch to 3 monthly.

There are other preparations available but these are not widely used locally.

What happens after I have the injection?

In the first week or two the Decapeptyl will stimulate your ovaries before switching them off and entering you into a menopausal state. You therefore may have a short period where your symptoms get worse but will gradually improve over the following month or two.

What side effects might I get?

The side effects of Decapeptyl are largely the result of low oestrogen levels and therefore similar to symptoms of the menopause. Side effects are common and most women will experience one or two. The severity of them varies from mild to severe.

Most women will experience hot flushes and or night sweats.

Other common side effects are

  • Vaginal dryness

  • Mood swings or anxiety

  • Reduced sex drive (libido)

  • Difficulty sleeping

  • Headaches

  • Weight changes

  • Muscle and joints aches

  • Thinning of bones (reduced bone density)

  • Pain & bruising at injection site

Less common side effects

  • Hair loss

  • Changes in eyesight

  • Memory loss

One of the more concerning side effects of this medicine is thinning of the bones.A single 6 month course of treatment for woman who have a normal bone density is not thought to be a concern as the bone can recover. If you have risk factors for osteoporosis then this treatment could cause a greater concern for your bone health.

Side effects can be reduced by giving “add-back” Hormone Replacement Therapy (HRT). Depending on your reason for being treated with Decapeptyl it may be possible to take HRT to combat the menopausal side effects without causing symptoms of the condition to recur. You can choose to start HRT when you start Decapaptyl.

Symptoms tend to gradually recur once Decapeptyl treatment is stopped unless other treatment has been initiated, for example insertion of Mirena or surgery for endometriosis.

Hormone replacement therapy (HRT)

Taking hormone replacement therapy is recommended if you are on this treatment for an extended time. It is probable that the risks associated with HRT do not apply to women who are taking GnRH analogues or have had a hysterectomy, unless they are naturally very near the age of menopause. This is because these women are just replacing hormones that their body would be producing naturally had they not had received either of these treatments.

Is Decapeptyl suitable for everyone?

No, you should not use it if:

  • You are allergic to Decapeptyl or any other GnRH agonists

  • Pregnant or breastfeeding

  • Have unexplained vaginal bleeding

  • Have a history of osteoporosis (thinning of bones)

Can I get pregnant?

Whilst your periods are likely to stop after a month or two, Decapeptyl cannot be relied upon as a form of contraception. Although you are unlikely to become pregnant we advise you continue to use a non-hormonal method of contraception, such as condoms or the copper coil.

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