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To determine whether length of pre-operative treatment with gonadotrophin-releasing hormone agonists (GnRHa) may have different effects on uterine shrinkage and intra-operative blood loss, 36 patients with symptomatic uterine fibroids awaiting myomectomy were randomly divided into two groups.Twenty patients received long-term GnRHa administration, six monthly depot injections of leuprolide acetate (LA), while 16 patients were treated with two monthly LA injections before surgery. The hemoglobin concentration and estradiol, follicle-stimulating hormone and luteinizing hormone concentrations were measured before and after treatment in both groups.Uterine volume decreased in the long-term treated group from 680+/-276 cm3 to 486+/-195 cm3 (36%) after two and to 388+/-172 cm3 (51%) after six LA injections. In the short-term treated group the basal uterine volume decreased from 745+/-320 cm3 to 456+/-177 cm3 (39%) after two LA injections. The uterine volume decrease was statistically significant (p0.05) after two LA injections in both groups while the decrease observed between two and six LA injections was not significant (p0.05). The intra-operative blood-loss was not significantly different between the two groups studied, 315+/-93 cm3 and 336+/-88 cm3.Two pre-operative GnRHa depot injections offer similar results, in terms of uterine shrinkage and intra-operative blood loss, and a longer treatment seems to be justified in cases of anemia.