Abstract
Menorrhagia is common in patients with uterine fibroids, if operation needs to be delayed for a particular reason, goserelin can be used safely to reduce bleeding and the size of the tumor.The objective is to compare between goserelin acetate and norethisterone on patients with menorrhagia and uterine fibroid. A randomized controlled study conducted in Elwiya maternity teaching hospital, Baghdad from the first of November 2007 to the end of April 2009. 90 patients from the consultant outpatient clinic with menorrhagia and fibroid, and their operations were delayed for medical reason were allocated in two groups, the first group, was given 3.2 mg goserelin acetate subcutaneously monthly for 3 months and the second group was given 5 mg norethisterone orally three times daily during the attack of bleeding and 5 mg once daily, cyclically if no bleeding for 3 months. The fibroid was measured in two dimensions, using convex real-time ultrasound before treatment and three months after treatment. Haemoglobin and the number of pads used were also reported before and after treatment, also the side effects in both groups and the need for operations.The size of fibroid in two dimensions measurement was reduced from 28.24 cm2 ± 6.14 to 12.3 cm2 ± 3.45 in the goserelin group (P=0.0001) versus 26.56 cm2 ± 5.96 to 25.22 cm2 ± 5.01 in the norethisterone group (P= 0.2589). The haemoglobin level was 9.28 gm/100ml ± 2.44 pre-treatment in the goserelin group and 11.2 gm/100ml ± 1.88 post-treatment (P= 0.0001) versus 10.08 gm/100ml ± 2.86, and 10.24 gm/100ml ± 2.46 respectively in the norethisterone group (P= 0.7798). The need for operation was decreased significantly in the goserelin group. Goserelin showed better patient response and reduction in the tumor size than norethisterone in treatment of patients with menorrhagia and uterine fibroids if operation is delayed for medical or other reasons.
 Key words: Goserelin, Norethisterone , Menorrhagia, Uterine Fibroid
Highlights
Uterine fibroids are the most common tumor in the female reproductive system
(9) Pre operative goserelin has been shown to decrease blood transfusion during operation and increase the post operative hemoglobin. [10]Goserelin was found to decrease the size of uterine fibroids. [11,12,13,14,15] In our study we used two dimensions measurement of the fibroid by ultrasound, as it can be done by the usual ultrasound equipment available in gynecology clinics; the reduction in the area of the fibroid was from 28.24± 6.14 cm2 to 12.3±3.45 which represent more than 50%
In a study done by Lumsden, 1994, on 71 ladies scheduled for hysterectomy for fibroid, and were divided in 2 groups, one was given Goserelin and the other placebo before operation and they found that the size of the fibroid is smaller in the Goserelin group, the haemoglobin level and the duration of the operation
Summary
Uterine fibroids are the most common tumor in the female reproductive system. They are estimated to occur in 25% of women of reproductive age. [1] In the USA, 30% of women will have had a hysterectomy by the age of 60 years and 60% will be performed to treat fibroids. [2] Hysterectomy or myomectomy remain the most common types of treatment and it is associated with high level of satisfaction. A Gonadotrophin releasing hormone (GnRH) agonist is a synthetic form of gonaderelin. It acts on the luteinizing hormone releasing hormone (LHRH) receptors in the pituitary gland, in the same way as natural gonadorelin.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
