Innovative Medical Treatment Options
Several innovative options are under investigation as possible future medical treatments for uterine leiomyomas:
Putting a medicated intra-uterine device (IUD) into the uterus can decrease a woman’s blood flow and reduce the size of her fibroids.
This new treatment is one way of avoiding surgery.
However, medicated IUDs are not suitable for women whose uteruses are greater than 12-week size.
There have been several small studies examining the use of GnRH antagonists in leiomyomas.
The primary advantage of antagonists over more widely used GnRH agonists is that antagonists have a faster onset of action.
However for long-term therapy, antagonists appear to have no advantage.
The progesterone antagonist, mifepristone (RU 486), has also been shown in small studies to induce uterine shrinkage and stop menstrual periods in women with fibroids.
However, this agent is not currently available in the United States.
Studies of the antifibrotic drug, pirfenidone, are also underway to determine if this agent is useful in the treatment of fibroids.
Other medical therapies including
- androgens (e.g., danazol, gestrinone),
- progestins (e.g., medroxyprogesterone acetate, depomedroxyprogesterone acetate, norethindrone),
- oral contraceptive pills
have also been used to control prolonged and/or profuse blood flow (menorrhagia) in women with leiomyomas, presumably by diminishing the endometrium (endometrial atrophy).
However, these medications do not consistently decrease uterus or fibroid volume and are often ineffective in controlling menorrhagia.
Androgens (e.g., danazol, gestrinone) are often referred to as male hormones.
Synthetic androgens can slow or stop the growth of fibroids and relieve the symptoms.
Drugs such as danazol can reduce the size of the fibroids and the uterus, and stop menstruation and anemia.
However, the side effects make many women reluctant to take them.
Potential side effects include weight gain, depression, anxiety, oily skin and hair, deepening of the voice, headaches, fatigue, hair loss, growth of facial and body hair, blood clots and liver problems.
Better know as the French abortion pill or RU-486, also may cause a decrease in size of myomas and often stops abnormal uterine bleeding.
But it has undesireable side effects.
It is not currently available in the United States.