What question did this study set out to answer?

The aim is to investigate the impact of goserelin acetate treatment on hepatic steatosis indices in premenopausal women with endometriosis.

March 25, 2026Open Access

The effect of the pharmacological cessation of menstruation with a GnRH analog on non-invasive hepatic steatosis indexes in women with endometriosis

Key Points

The aim is to investigate the impact of goserelin acetate treatment on hepatic steatosis indices in premenopausal women with endometriosis.
Conducted a post-hoc analysis of an interventional study.
Measured non-invasive indices of hepatic steatosis and fibrosis pre-treatment, 6 months after treatment, and after treatment cessation.
Compared indices in the intervention group (21 women on goserelin) to a control group (27 matched women).
No significant changes in hepatic steatosis indices were observed after 6 months of goserelin treatment.
MetS-IR showed a numerical change but was not significantly different after Bonferroni correction.
Insulin resistance and lipid profiles worsened during the treatment period.

Abstract

Purpose: Menopause is associated with metabolic dysfunction-associated steatotic liver disease (MASLD). This study primarily aimed to evaluate changes in non-invasive indices of hepatic steatosis and fibrosis in premenopausal women with endometriosis after treatment with goserelin acetate, resulting in a reversible pharmacologic menopause. Methods: This was a post-hoc analysis of an interventional study. Non-invasive indices of hepatic steatosis and, secondarily, fibrosis were calculated in premenopausal women with endometriosis (intervention group, n=21) before (baseline), 6 months after goserelin treatment (estrogen-deficient period), and 6 months after goserelin discontinuation (estrogen replenishment period). Age- and body mass index (BMI)-matched premenopausal women were recruited for baseline comparisons (control group, n=27). Hepatic steatosis was evaluated using the Hepatic Steatosis Index (HSI), Triglyceride/Glucose Index (TyG), TyG-BMI, Triglyceride/High Density Lipoprotein (TG/HDL), Metabolic Score for Insulin Resistance (MetS-IR), Dallas Steatosis Index (DSI) and Framingham Steatosis Index (FSI). Hepatic fibrosis was evaluated with BMI – Aspartate Aminotransferase (AST)/Alanine Aminotransferase (ALT) Ratio Diabetes Mellitus (BARD). Results: The non-invasive indices of hepatic steatosis and BARD were similar between patients and controls at baseline and did not significantly change after goserelin treatment, except for MetS-IR, which showed an overall significant change (p=0.04); however, in pairwise comparisons after Bonferroni correction, no significant difference in MetS-IR was observed between baseline (34.8 ± 7.7), month 6 (33.3 ± 9.0), and endpoint (35.0 ± 8.1) values. As expected, lipid profiles and insulin resistance worsened during the study. Conclusion: Non-invasive hepatic steatosis and BARD indices were not significantly affected by estrogen deficiency caused by 6-month goserelin treatment in premenopausal women with endometriosis.

The effect of the pharmacological cessation of menstruation with a GnRH analog on non-invasive hepatic steatosis indexes in women with endometriosis

Key Points

Abstract

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