Lupron: The Induced Menopause
Written by Emily.
Lupron is one of those medications in the infertility business that I feel like everyone gets at one time or another, largely because it's such a diverse medication.
Let’s start with the basics - what is Lupron?
Lupron is a GnRH agonist - GnRH meaning gonadotropin releasing hormone, agonist meaning it works with your body to initially increase the release of two primary hormones involved in mature egg selection - FSH (follicle stimulating hormone) and LH (luteinizing hormone).
Lupron has one of the most diverse profiles for clinical use of any medication - ranging from a medication used in the treatment of cancer (primarily breast and prostate), to being used as a trigger shot for egg donors, to being used to suppress the ovaries and prepare the body for embryo transfer.
Lupron, when used for longer periods of time, actually has a paradoxical effect where it suppresses hormones rather than trigger them.
For Abby and her egg donation journey, she received a one-time dose of Lupron prior to her egg retrieval that worked with the HCG trigger shot to prepare the eggs for the final push in maturation.
For me, I received this injection daily over the course of about a month with the intended goal being to wipe out my hormones - in layman’s terms, putting my reproductive system to sleep so we could control every phase of the cycle using various medications.
And it was just as miserable as it sounds.
My underlying condition - primary ovarian failure - is often nicknamed “early menopause” because the condition itself is diagnosed due to under functioning or non-functioning ovaries. Women with the condition have to receive daily estrogen and cycles of progesterone to maintain hormonal regularity and prevent menopausal symptoms. When finding the “just right” dose of these, women often experience menopausal symptoms.
I was no different - I was familiar with menopausal symptoms and have experienced them at various stages of my life as early as 14/15, and since then they recur just about every time a medication is changed or a refill is delayed.
But nothing quite compared to the complete and total hormonal washout Lupron gave me.
The first week was status quo - maybe a little extra tired, but overall feeling good - we were finally starting the process! Vibes were high.
By week two, things really started to take a turn. I felt fatigued and had significant brain fog - it felt like I was moving in slow motion while the world around me moved at a high pace.
By week 3, I was still feeling the fatigue and brain fog, but now we’ve added in cycles of hot flashes and chills, accompanying deep bone aches. I genuinely felt like I had the flu, but there was no fever, no congestion, no actual sick symptoms - just body aches, temperature dysregulation, brain fog, and fatigue…… lovely.
I will say probably the only positive - once the symptoms peaked, they stayed there and did not continue to build in intensity or frequency. Week 3 was the worst, and we stayed there for week 4.
Eventually I started the progesterone injections prepping for transfer, then had the embryo transfer, and continued the progesterone injections for several months after. Once the progesterone was started, those menopausal symptoms did improve a bit, and of course once the Lupron was stopped, I felt better within a matter of days.
It was so temporary, but it was also so hell.
I write this to share a little awareness - I was not prepared for the Lupron phase of the cycle. People will warn you about the progesterone injections, scare you about the internal ultrasounds, and prep you for the frequent labs and pokes during the IVF process, but nobody had warned me about the Lupron phase.
If I had gone into the start of our cycle - and the start of Lupron - knowing what was going to happen and how I’d be feeling, I would’ve prepped a little better. Food prep some freezer meals, set yourself up for a low-responsibility month, try not to commit to any obligations with friends and family, and lay low for a bit. I started Lupron over the holidays, and could not recommend against this more. Obviously you don’t always have control, but if you do - plan ahead.
And if all else fails and you can’t tailor your timing just right, have a ton of responsibilities during your Lupron month, and don’t know how you’ll manage - at least prep your partner. A quick “hey, this medication is supposed to wipe me out pretty good. If I’m moody and short with you this month, its not you, it's because I feel like crap” and make a game plan for how to support you and support your household through this phase.
