Role of Low-Dose Mifepristone for Managing Uterine Leiomyoma

Abstract

Objective: The aim of this research was to assess the decrease in uterine volume and fibroid volume in patients with uterine leiomyoma who were receiving low-dose mifepristone for 3 months as well as evaluating relief in symptoms produced by this medication. Design: This was a prospective study carried out in a tertiary-care center. Materials and Methods: Fifty women (ages 30–50) with symptomatic uterine leiomyoma were given 10 mg of mifepristone per day for 3 months. The patients' decrease in menstrual and pressure symptoms and reduction in uterine and fibroid volume, measured by transvaginal sonography, were assessed at the end of 3 months of treatment and after 3 months of stopping treatment. Results: There was a significant reduction in the patients' uterine and fibroid volume at the end of 3 months. The mean reductions in uterine and fibroid volume after 1 month were up to 9.6% and 11.1%, respectively; after the second month, they were respectively, 18.3% and 21.4%; and after the third month, they were respectively, 27.8% and 32.1% (p<0.001). Three months after stopping treatment there was a slight increase in these parameters (p<0.001), but uterine and fibroid volume were still 26.25% and 27.24%, respectively, lower than baseline. There was significant reduction of menorrhagia, dysmenorrhea, and pressure symptoms of bladder frequency and pelvic pain at the end of 3 months (p<0.001), which increased slightly (p<0.05) after 6 months. According to the results of endometrial sampling, no patient had any complex hyperplasia or any atypical hyperplasia. The side-effects of the medication were minimal. Conclusions: Low-dose mifepristone had a shrinking effect on the patients' fibroid growths. It produced a definite reduction in the the patients' symptoms with few side-effects. (J GYNECOL SURG 30:70)