As GnRH agonists (GnRHa) result in continued receptor stimulation, as opposed to ultradian cyclic changes, theiradministration initially results in an increase in LH and FSH secretion (‘flare-effect’), followed by the down-regulation of GnRH receptor expression in the pituitary gland and suppression of reproductive axis function (Garner, 1994, Chen and Eugster, 2015). GnRHa is typically prescribed when the suppression of the reproductive axis is required, such as steroid-sensitive conditions like prostate cancer, uterine fibroids and endometriosis (Garner, 1994). In children and adolescents, GnRHa can be prescribed for treatment of central precocious puberty (CPP) (Chen and Eugster, 2015) and gender dysphoria (GD) (Hembree et al., 2009) to temporarily halt reproductive development.