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Uterine Fibroids (cont.)

Medications

Patients may be given nonsteroidal anti-inflammatory drugs, oral contraceptives (birth control pills), gonadotropin releasing hormone agonists, or RU-486.

  • Nonsteroidal anti-inflammatory agents, such as ibuprofen (Advil is one example), have been shown to relieve pelvic pain associated with fibroids.
  • Oral contraceptive pills are also commonly used in women with fibroids. They often decrease perceived menstrual blood flow and help with pelvic pain.
  • Gonadotropin releasing hormone (GnRH) agonists are medications that act on the pituitary gland to decrease estrogen produced by the body. A decrease in estrogen causes fibroids to decrease in size. This type of medication often is used prior to surgery to shrink the fibroid, to decrease the amount of blood loss during surgery, or to improve preoperative blood count. The size of the fibroid can be reduced by 50% in three months with of this type of therapy. But fibroids can regrow once treatment is stopped. Long-term therapy with these medications is limited by the side effects of low estrogen (much like menopause), which include decreased bone density, osteoporosis, hot flashes, and vaginal dryness.
  • The antihormonal drug RU-486 (mifepristone) has also been shown to reduce fibroid size by about half. This drug has also been shown to reduce pelvic pain, bladder pressure, and lower back pain. Low doses of this drug may reduce the size of fibroids in preparation for surgery to remove them. It may also help some patients avoid surgery entirely by shrinking the fibroids and the problems they are causing. Side effects related to low estrogen, seen with GnRH analogs, may be less common. RU-486 can induce miscarriage, so this medication should be used with caution if a woman is trying to conceive.
  • The drug danazol (Danocrine) has been used to reduce bleeding in women with fibroids, since this drug causes menstruation to cease, but it does not shrink the size of fibroids. Danazol is an androgenic (male) hormonal drug that can cause serious side effects including weight gain, muscle cramps, decreased breast size, acne, hirsutism (inappropriate hair growth), oily skin, mood changes, depression, decreased high density lipoprotein (HDL or 'good cholesterol') levels, and increased liver enzyme levels.
  • Another new drug may be useful in treating some uterine fibroids. It is a progesterone receptor modulator named EllaOne. It is used as an emergency contraception drug, but was found to shrink fibroids and reduce bleeding associate with fibroids.
Medically Reviewed by a Doctor on 5/9/2014

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