Clinical efficiency of using selective progesterone receptor modulators in the treatment of symptomatic uterine fibroids

Objective. To investigate of the efficacy of the selective progesterone receptor modulator in treating uterine fibroids of different types and sizes Subjects and methods. The investigation enrolled 30 women with uterine fibroids who experienced pain and heavy menstrual periods. The patients took ulipristal acetate, a synthetic selective progesterone receptor modulator, at a dose of 5 mg/day for 12 weeks. Intensity of pain syndrome, volume of bleeding, volume of the uterus and dominant nodules, and sizes of nodules were assessed according to sonographic and Doppler findings before and after a therapy cycle. Conclusion. After completing a treatment cycle, pain intensity decreased from 6.6 to 4.4 scores due to the absence of patients reporting unsufferable and severe pain. 85.7%o of patients who complained of heavy menstrual periods achieved uterine bleeding control on day 7 after treatment initiation. After the first cycle of therapy with uliprystal acetate, there were decreases in the uterine volume exceeding 3-5-fold the normal values (p < 0.05) and in the nodular sizes that had been larger than 6 cm before treatment (p < 0.05). This resulted in a 1.9-fold decline in the number of cases of nodules greater than 100 cm3. Such alterations stemmed from drug- induced changes in nodular blood flow. There was a significant increase in vascular resistance and a decrease in blood flow, especially in mosaic one, indicating a decline in the number of arteriovenous anastomoses between the newly formed vessels.

uterine fibroids, abnormal uterine bleeding, ultrasonography, pain syndrome, selective progesterone receptor modulator, ulipristal acetate