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Fibroid Uterus Diagnosis Treatment

1. Gonadotropin-releasing hormone (Gn-RH) agonists. GnRH analogues are a well established option for medical management of myomas, but their use is not widespread Medications called Gn-RH agonists treat fibroids by blocking the production of estrogen and progesterone, putting you into a temporary postmenopausal state. As a result, menstruation stops, fibroids shrink and anemia often improves. Your doctor may prescribe a Gn-RH agonist to shrink the size of your fibroids before a planned surgery.

2. Progesterone Receptor Modulator With Primarily Antagonistic Properties It binds strongly to endometrial progesterone receptors, minimally to estrogen receptors and upregulates androgen receptors. In a placebo controlled trial low dose mifepristone has been shown to decrease myoma size as well as symptoms. Reduction in size with mifepristone might be due to the direct effect in reducing number of progesterone receptors. Besides, because of ovarian acyclicity seen with mifepristone, hormonal milieu similar to early follicular phase may also inhibit steroid dependent growth of myoma. Increase in androgen receptors also contributes to antiproliferative effects. Mifepristone also delays or inhibits ovulation, which may produce amenorrhoea. Direct suppressive effects on endometrial vasculature as well as on reducing stromal vascular endothelial growth factor (VEGF) has also been suggested for reducing menstrual blood loss.

Mifepristone, on the other hand, is administered orally, has a few side effects and is less expensive than GnRH analogues. If proved to be an effective medical treatment option for uterine myoma, it may be a cost-effective substitute for GnRH analogues in low-resource settings.




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