- Prostate Cancer Slideshow Pictures
- Medical Illustrations of the Prostate Image Collection
- Men's Screening Tests Slideshow
Does Lupron (leuprolide) cause side effects?
Lupron (leuprolide) is a man-made hormone used to treat prostate cancer, endometriosis, central precocious puberty (early onset of puberty), and fibroids. It is similar to but stronger than human gonadotropin releasing hormone (GnRH).
GnRH is made in the hypothalamus (a part of the brain) and travels to the pituitary gland where it causes the production of luteinizing hormone (LH) and follicle stimulating hormone (FSH). LH and FSH are released by the pituitary into the blood and stimulate the production of testosterone by the testes in men and estrogens by the ovaries in women.
The release of GnRH, LH and FSH is governed by negative feedback which means that when there is too much testosterone or estrogen being produced, the body sends a signal to the pituitary gland to reduce the production of GnRH which, in turn reduces the production of LH and FSH.
This results in reduced production of testosterone and estrogen. When given continuously, Lupron initially increases the production of LH and FSH as well as testosterone and estrogen; however, after a few weeks of continuous Lupron, the levels of LH and FSH drop because the pituitary gland stops responding to GnRH and leuprolide.
This leads to a decrease in the production of estrogen and testosterone. Testosterone promotes the growth of prostate cancer. Lupron is used in treating prostate cancer to slow the growth of the cancer.
In children with central precocious puberty (puberty caused at an early age because of too much LH and FSH) Lupron, by suppressing LH and FSH, reduces the levels of estrogen and testosterone and allows for more normal timing of puberty.
Estrogens promote the growth of fibroids (benign tumors of the uterus) and areas of endometriosis (abnormal uterine tissue that exists outside of the uterus). Lupron is used to reduce the production of estrogen and treat both fibroids and endometriosis.
Common side effects of Lupron include
- aches and pain,
- fluid retention (edema),
- hot flashes,
- chest pain, and
- irritation at the injection site.
Other important side effects of Lupron include
Serious side effects of Lupron include
- rare cases of suicidal behavior,
- low blood pressure,
- convulsions, and
- joint pain and muscle aches.
No drug interaction studies have been done for Lupron. Lupron should not be administered to pregnant women because there is a high chance of harm to a fetus. The effects of Lupron on the infant have not been studied in women who are breastfeeding. Consult your doctor before breastfeeding.
What are the important side effects of Lupron (leuprolide)?
The most common side effects of leuprolide are:
- aches and pain,
- hot flashes,
- chest pain, and
- irritation at the injection site.
Other important side effects of leuprolide include:
Lupron (leuprolide) side effects list for healthcare professionals
- In the majority of patients testosterone levels increased above baseline during the first week, declining thereafter to baseline levels or below by the end of the second week of treatment.
- This transient increase was occasionally associated with a temporary worsening of signs and symptoms, usually manifested by an increase in bone pain.
- In a few cases a temporary worsening of existing hematuria and urinary tract obstruction occurred during the first week.
- Temporary weakness and paresthesia of the lower limbs have been reported in a few cases.
- Potential exacerbations of signs and symptoms during the first few weeks of treatment is a concern in patients with vertebral metastases and/or urinary obstruction which, if aggravated, may lead to neurological problems or increase the obstruction.
- In a comparative trial of Lupron Injection (leuprolide acetate) versus DES, in 5% or more of the patients receiving either drug, the following adverse reactions were reported to have a possible or probable relationship to drug as ascribed by the treating physician.
- Often, causality is difficult to assess in patients with metastatic prostate cancer.
- Reactions considered not drug related are excluded.
|Number of Reports|
|Congestive heart failure||1||5|
|High blood pressure||8||5|
|*Decreased testicular size||7||11|
|*Gynecomastia/breast tenderness or pain||7||63|
|Hemic and Lymphatic System|
|Central/Peripheral Nervous System|
|Urinary tract infection||3||7|
|* Physiologic effect of decreased testosterone.|
In this same study, the following adverse reactions were reported in less than 5% of the patients on Lupron.
Endocrine System—Libido decrease, Thyroid enlargement;
Musculoskeletal System—Joint pain;
Miscellaneous—Depression, Diabetes, Fatigue, Fever/chills, Hypoglycemia, Increased BUN, Increased calcium, Increased creatinine, Infection/inflammation, Ophthalmologic disorders, Swelling (temporal bone).
In an additional clinical trial and from long-term observation of both studies, the following additional adverse events (excluding those considered not drug related) were reported for patients receiving Lupron.
Gastrointestinal System—Flatus, Dryness of mouth and throat, Hepatitis, Hepatomegaly, Occult blood (rectal exam), Rectal fistula/erythema;
Endocrine System—Libido increase, Thyroid nodule;
During postmarketing surveillance which includes other dosage forms and other patient populations, the following adverse events were reported.
Localized reactions including induration and abscess have been reported at the site of injection.
Cardiovascular System -Hypotension, Myocardial infarction;
Endocrine System -Diabetes;
Gastrointestinal System -Hepatic dysfunction;
Hemic and Lymphatic System -Decreased WBC;
Integumentary System -Hair growth;
Miscellaneous -Hard nodule in throat, Weight gain, Increased uric acid;
Musculoskeletal System -Tenosynovitis-like symptoms;
Respiratory System -Respiratory disorders.
Changes in Bone Density: Decreased bone density has been reported in the medical literature in men who have had orchiectomy or who have been treated with an LH-RH agonist analog. In a clinical trial, 25 men with prostate cancer, 12 of whom had been treated previously with leuprolide acetate for at least six months, underwent bone density studies as a result of pain. The leuprolide-treated group had lower bone density scores than the nontreated control group. It can be anticipated that long periods of medical castration in men will have effects on bone density.
Pituitary apoplexy: During post-marketing surveillance, rare cases of pituitary apoplexy (a clinical syndrome secondary to infarction of the pituitary gland) have been reported after the administration of gonadotropin-releasing hormone agonists. In a majority of these cases, a pituitary adenoma was diagnosed, with a majority of pituitary apoplexy cases occurring within 2 weeks of the first dose, and some within the first hour. In these cases, pituitary apoplexy has presented as
- sudden headache,
- visual changes,
- altered mental status, and
- sometimes cardiovascular collapse.
Immediate medical attention has been required.
See other Lupron Depot and Lupron Injection package inserts for other events reported in the same and different patient populations.
Lupron (leuprolide) is a man-made hormone used to treat prostate cancer, endometriosis, central precocious puberty (early onset of puberty), and fibroids. Common side effects of Lupron include aches and pain, fatigue, fluid retention (edema), headaches, hot flashes, chest pain, and irritation at the injection site. Other important side effects of Lupron include impotence, shrinking of the testes, and breast enlargement in men (gynecomastia). Lupron should not be administered to pregnant women because there is a high chance of harm to a fetus. The effects of Lupron on the infant have not been studied in women who are breastfeeding.
Multimedia: Slideshows, Images & Quizzes
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Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They also can be found in the vagina, cervix, and bladder. Endometriosis may not produce any symptoms, but when it does the most common symptom is pelvic pain that worsens just prior to menstruation and improves at the end of the menstrual period. Other symptoms of endometriosis include pain during sex, pain with pelvic examinations, cramping or pain during bowel movements or urination, and infertility. Treatment of endometriosis can be with medication or surgery.
Prostate cancer is the most common cancer in men after skin cancer. Risk factors include age, family history, ethnicity, and diet. Prostate cancer is diagnosed by digital rectal exam, prostate specific antigen (PSA) test, and prostate biopsy. Symptoms may include frequent need to urinate, incontinence, pain, blood in the urine, fatigue, and more. Prognosis and treatment depend on cancer staging. Watchful waiting, surgery, radiation, cryotherapy, and other management strategies are available. Research and clinical trials strive to find new and better treatments for prostate cancer.
Central Precocious Puberty?
Central precocious puberty is characterized by the unusual early onset of puberty -- in girls, prior to 8 years of age, and boys, prior to 9 years of age. The appearance of secondary sex changes -- enlargement of penis and testicles and development of breast tissue and facial, pubic, and axillary hair -- in central precocious puberty precedes that of routine onset of puberty by two and a half years. Treatment of central precocious puberty depends upon the cause.
Prostate Cancer (Prostatic Cancer) Symptoms and Causes
Difficulty with urination – frequency, weak stream, trouble getting started, etc. – is usually the first sign of prostate cancer. But these and other early symptoms of prostatic cancer can also come from benign prostate conditions, so diagnostic testing is important, including PSA tests and digital rectal exam.
How Is Prostate Cancer Diagnosed?
Prostate cancer is largely a disease of men over 40, so it’s around this age doctors recommend the first prostate screening. The first exam is a blood test to determine if there are abnormal prostate specific antigen (PSA) levels in your blood – PSA is produced by the prostate. If the PSA is high, your doctor will perform a digital rectal exam, during which the doctor feels your prostate from inside your rectum with a gloved finger. Other diagnostic tests include an endoscopic biopsy of tumor tissue for analysis in a lab.
Prostate Cancer Staging and Prognosis
The prognosis for prostate cancer, as with any cancer, depends on how advanced the cancer has become, according to established stage designations. The patient's PSA score at diagnosis, as well as their Gleason score (the grading system used to determine the aggressiveness of prostate cancer) determines the prognosis and final stage designation. Prostate cancer has a high survival rate in general, but your chances depend on the stage of the cancer.
Early-Stage Prostate Cancer Treatment
If prostate cancer is detected early and appears to be slow-growing, invasive procedures, chemotherapy, radiation and other approaches can sometimes do more harm than good. Many prostate cancer treatments come with side effects, like incontinence or impotence, so it’s in the patient’s interest to put off invasive treatments as long as is medically safe. Active surveillance is where doctors "watch and wait" for changes that could prompt medical intervention.
Prostate Cancer Treatment: Radical Prostatectomy Surgery
Radical prostatectomy, or surgical removal of the entire prostate gland, isn’t typically the first choice in prostate cancer treatment. Sometimes a radical approach is necessary to keep the cancer from metastasizing, however. Some cases are too severe or diagnosed too late for drugs or radiation to have much effect. In these cases, treatment teams may opt for a radical prostatectomy, despite potential side effects like impotence and incontinence.
Prostate Cancer Treatment: Chemotherapy, Bone-Targeted and Immune Therapy
Doctors may introduce chemotherapy and immune therapy if other measures fail to cure a case of prostate cancer. However, unlike with other forms of cancer, chemotherapy isn’t the first choice for early prostate cancer. Immune therapy uses the body's own immune system to attack the prostate tumor, while bone-targeted therapy aims to preserve bone and prevent metastasis.
Prostate Cancer Treatment: Radiation, Brachytherapy and Radiopharmaceuticals
Radiation treatment for prostate cancer is a powerful tool at doctors’ disposal. Using radiation vs. surgery or other invasive treatments to kill cancer cells may still cause side effects, but ideally they are less severe. Radiation therapy can be performed via external beam therapy (EBRT) or the placement of radioactive seeds into the prostate (prostate brachytherapy) or using radioactive drugs (radiopharmaceuticals).
Prostate Cancer Treatment: Hormonal Therapy
Prostate cancer is highly sensitive to, and dependent on, the level of the male hormone testosterone, which drives the growth of prostate cancer cells. Testosterone belongs to a family of hormones called androgens, and today front-line hormonal therapy for advanced and metastatic prostate cancer is called androgen deprivation therapy (ADT).
Prostate Cancer Treatment: Focal Therapy and Other Experimental Treatments
Several new and experimental treatments for prostate cancer are under study, including treatments that use ultrasound, lasers, tissue-freezing gas, and new ways of administering radiation. These new methods are types of focal therapy, that is, treatment focused on the cancer cells in the prostate, rather than systemic therapy that administers medications or other treatments to the whole body with the aim of treating the prostate.
Prostate Cancer Facts
Prostate cancer is a leading cause of cancer and cancer death in males; in some men, identifying it early may prevent or delay metastasis and death from prostate cancer. The prostate is a walnut-shaped gland that is a part of the male reproductive system that wraps around the male urethra at it exits the bladder. Prostate cancer is common in men over 50 years of age, with the risk of developing prostate cancer increases with aging.
What Are the Early Signs of Endometriosis?
The endometrium is the inner lining of the uterus, which changes throughout the menstrual cycle, shedding during menstrual periods. Endometriosis is the presence of normal endometrial tissue abnormally implanted in locations other than the inner wall of the uterus. This causes pain and other symptoms that may include infertility.
What Are the 5 Warning Signs of Prostate Cancer?
Prostate cancer rarely produces symptoms in the early stage; however, few signs can help in detecting prostate cancer.
How Do I Know If I Have Endometriosis?
Approximately, one-third of the women with endometriosis remain asymptomatic. Severe pain during menses may be the first sign of endometriosis. Other symptoms that you may experience include heavy periods, low back pain, cramps, pain during intercourse and other symptoms.
The early signs of prostate cancer
Prostate cancer in its early stages usually causes no signs and symptoms. Screening can help detect the cancer early.
Can Prostate Cancer Be Completely Cured?
Prostate cancer is the second most common cancer in men. Due to routine screening of prostate-specific antigen (PSA) levels in the United States, nearly 90% of prostate cancers get detected in early stages. When found early, there are several treatment options available and prostate cancer has a high chance of getting cured.
Treatment & Diagnosis
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Medications & Supplements
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.