Effect of ulipristal acetate on leomyoma of uterus

Abstract

Background: The efficacy and side-effect profile of ulipristal acetate (UPA) for the treatment of symptomatic uterine fibroids before surgery are unclear. Main objective of the study to see the effect of UPA on leomyoma. Methods: An observational clinical trial was conducted at the department of gynaecology and obstetrics, Sir Salimullah medical college and Mitford hospital, Dhaka, from January to June 2015. Thirty women aged 18-48 with symptomatic fibroid uterus were studied. They received Tablet UPA 5 mg/day for 3 months. Evaluation included history taking, physical examination, pelvic ultrasonography, and necessary investigations. Results: The majority of patients (43.3%) were ≤30 years old. Before intervention, heavy bleeding was observed in all patients until the 8th day of menstruation. During intervention, majority had no bleeding from the 5th to 8th day, with only a few experiencing heavy bleeding on the 7th and 8th day. After intervention, most patients had no bleeding from the 5th to 8th day, with a few reporting spotting on the 5th day. Before treatment, 60% had fibroid size >10 cm2. After treatment, 92.3% had fibroid size <10 cm2, with 7.7% showing no fibroids. Mean uterine size decreased post-treatment. Majority (57.7%) had hemoglobin >11 gm/dl. Side effects included headache (11.5%), hot flashes (15.4%), and nausea/vertigo (19.2%). Treatment success rate was 86.7%. Conclusions: In a group of selected patients with fibroid uterus and heavy menstrual bleeding, UPA (5 mg/day for 3 months) successfully decreases blood loss and shrinks fibroid and uterine size by 86.7%.