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......puberty is a critical and "once only" time for multiple, very important changes to the body. Even if the effect of the drug is limited to the duration of the drug, that WINDOW OF TIME is never recovered. Importantly the time it takes for a GnrH agonist to wear off can be quite variable - especially depending on which form of the drug is given (longer lasting depot version vs short acting monthly injections). It can take anywhere from 3 months to two years to rid the body full of effects in the latter's case.
During that period, the critical time needed for full secondary sexual characteristic development is not taking place.

Also, bone mineral density deposition occurs early in life with peak density being reached in the early 20's. When you lose the effect of estrogen and testosterone (and the interconversion between the two) as happens when a drug that suppresses the gonadotropin releasing hormones is given, osteoporosis can develop - we see this in patients with natural hypogandism, and expect to see it in any situation where hypogonadism is induced with medication as well. While the process can be monitored and abandoned when this issue arises the patient STILL HAS TO WAIT FOR THE DRUG TO WEAR OFF and importantly THE PATIENT IS STILL LOSING OUT ON THE ONLY TIME IN LIFE WHEN BONE DENSITY IS BEING ADDED.
When these GnrH agonists are used in adults - say to treat severe endometriosis before surgery, to diagnose the etiology of pelvic pain, or to "shut things down" prior to jump starting ovulation with fertility drugs - the effects of these drugs have not found to be significant enough to stop treatment. But that is a different situation because those are adult patients who were not missing their limited time for bone deposition.

In adolescents taking these meds, they can experience long term changes in bone density (and high risk for osteoporosis), bone growth and final height. You can give the kids Vit D and Calcium, but that is just spitting in the wind compared to the overwhelming impact of the gonadal shut down which shuts down osteoblastic activity (the brick layer cells so to speak) such that the calcium (the bricks) and the Vitamin D (which helps with the delivery of the bricks to the worksite) are of very minimal benefit since the osteoblasts (bricklayer) isn't working. Further, their are also cells that work to resorb born (osteoclasts), and these cells become more active in the ratio of osteblast/osteoclast activity, such that bone resorption predominates during the effects of these drugs during a special time when naturally the opposite would be happening and deposition would be dominating...again - special time that only occurs early in life, and benefit of even some loss of that time can never be fully retrieved. There is the possibility of very expensive medications over long periods of time to attempt to address this, but this has no guarantees of working well with longterm cost, follow up, and potentially a permanent need.

This treatment of GnrH agonsts at this age can also permanently effect fertility because of their impact on follicles and spermatazoa production capability.

Basically, who cares if the drug is reversible if the effects are not always reversible - (the longer the treatment in that critical window, the higher the chance for permanent sequelae). And again, the drug does not wear off evenly for everyone and can have persistent effects for a long time in patients here who don't have much of a window of time.
The effects can be permanent (the important issue), so a claim that the drug that causes it wears off (is "reversible) would be a deceitful thing to pass off without mentioning this important distinction. Anyone seeking medical advice should speak to their own doctor and bring up these issues to discuss, I don't give that here (necessary disclaimer).
You know that they say about absolute claims like "totally reversible". You see that a lot with Google experts.

PS - sry for edits - having lots of typing issues today.