Abstract
Purpose
Uterine leiomyomas are the most common benign tumors of reproductive age women, but there is no effective medical therapy to data. Aim of this study was to examine and compare the efficacy of gonadotropin-releasing hormone agonist (GnRHa) versus dienogest in premenopausal women with uterine myoma.
Methods
We retrospectively analyzed the medical records of 55 premenopausal patients with endometriosis, who received dienogest (2 mg daily) for 6 months regarding coexistence of uterine myoma between January 2008 and June 2010. To compare these data in a case–control study, we analyzed a matched control group of 12 patients treated with leuprolide acetate (1.88 mg monthly) for 6 months having uterine myoma.
Results
Of the 55 patients treated with dienogest, six were associated with coexistent myoma node. Total myoma volume significantly decreased to 59.7 ± 7.0% of initial in dienogest group and 51.9 ± 5.5% in GnRHa group. Reduction rate in myoma volume was similar in both groups.
Conclusion
Uterine myoma volume was successfully reduced by use of dienogest. Consideration of GnRHa disadvantages may lead to short- or long-term management of women with myoma who are to be managed transiently, and who wish to avoid surgical intervention, especially perimenopausal women.
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References
Levy B (2008) Modern management of uterine fibroids. Acta Obstet Gynecol Scand 87:812–823
Parker W (2007) Uterine myomas: management. Fertil Steril 88:255–271
Sankaran S, Manyonda I (2008) Medical management of fibroids. Best Pract Res Clin Obstet Gynaecol 22:655–676
Schweppe K (1999) Progestins and uterine leiomyoma. Gynecol Endocrinol 13(Suppl 4):21–24
Sasagawa S, Shimizu Y, Kami H et al (2008) Dienogest is a selective progesterone receptor agonist in transactivation analysis with potent oral endometrial activity due to its efficient pharmacokinetic profile. Steroids 73:222–231
Sitruk-Ware R (2006) New progestagens for contraceptive use. Hum Reprod Update 12:169–178
Harada T, Taniguchi F (2010) Dienogest: a new therapeutic agent for the treatment of endometriosis. Womens Health 6:27–35
Harada T, Momoeda M, Taketani Y et al (2009) Dienogest is as effective as intranasal buserelin acetate for the relief of pain symptoms associated with endometriosis–a randomized, double-blind, multicenter, controlled trial. Fertil Steril 91:675–681
Köhler G, Faustmann T, Gerlinger C, Seitz C, Mueck A (2010) A dose-ranging study to determine the efficacy and safety of 1, 2, and 4 mg of dienogest daily for endometriosis. Int J Gynaecol Obstet 108:21–25
Schindler A, Christensen B, Henkel A, Oettel M, Moore C (2006) High-dose pilot study with the novel progestogen dienogestin patients with endometriosis. Gynecol Endocrinol 22:9–17
Strowitzki T, Marr J, Gerlinger C, Faustmann T, Seitz C (2010) Dienogest is as effective as leuprolide acetate in treating the painful symptoms of endometriosis: a 24-week, randomized, multicentre, open-label trial. Hum Reprod Update 25:633–641
Strowitzki T, Faustmann T, Gerlinger C, Seitz C (2010) Dienogest in the treatment of endometriosis-associated pelvic pain: a 12-week, randomized, double-blind, placebo-controlled study. Eur J Obstet Gynecol Reprod Biol 151:193–198
Huang J, Lathi R, Lemyre M, Rodriguez H, Nezhat C, Nezhat C (2010) Coexistence of endometriosis in women with symptomatic leiomyomas. Fertil Steril 94:720–723
Parsanezhad M, Azmoon M, Alborzi S et al (2010) A randomized, controlled clinical trial comparing the effects of aromatase inhibitor (letrozole) and gonadotropin-releasing hormone agonist (triptorelin) on uterine leiomyoma volume and hormonal status. Fertil Steril 93:192–198
Endrikat J, Graeser T, Mellinger U, Ertan K, Holz C (2007) A multicenter, prospective, randomized, double-blind, placebo-controlled study to investigate the efficacy of a continuous-combined hormone therapy preparation containing 1 mg estradiol valerate/2 mg dienogest on hot flushes in postmenopausal women. Maturitas 58:201
Momoeda M, Harada T, Terakawa N et al (2009) Long-term use of dienogest for the treatment of endometriosis. J Obstet Gynaecol Res 35:1069–1076
Schindler A, Henkel A, Moore C, Oettel M (2010) Effect and safety of high-dose dienogest (20 mg/day) in the treatment of women with endometriosis. Arch Gynecol Obstet doi:10.1007/s00404-009-1301-z
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Ichigo, S., Takagi, H., Matsunami, K. et al. Beneficial effects of dienogest on uterine myoma volume: a retrospective controlled study comparing with gonadotropin-releasing hormone agonist. Arch Gynecol Obstet 284, 667–670 (2011). https://doi.org/10.1007/s00404-010-1732-6
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DOI: https://doi.org/10.1007/s00404-010-1732-6