Effect of Progestin-Dominant Combined Oral Contraception on Uterine Fibroid Development (original) (raw)

Background: Combined oral contraception blocks the endogenous ovarian steroid secretion that stabilizes the hormonal environment. Monophasic, progestin-dominant, contraceptives may lead to regression of estrogendependent diseases such as uterine fibroids and endometriosis. Study Design: The purpose of our randomized, controlled, single-blind, prospective observational study was to document the development of uterine fibroids exposed to the influence of combined oral contraceptive with progestin dominancy. A total of 129 patients were randomly divided into 2 groups: 97 women with one or multiple uterine fibroids treated conservatively with monophasic hormonal pills containing 20mcg of ethinyl estradiol and 75mcg of gestodene were observed for a period of 2 to 4 years, and 32 women in the control group. Results: In 75 patients (77.3% vs. 31.2% of untreated controls), regression or no growth was registered. In 22 patients (22.7%), the size of myoma increased, menstruation irregularity and heavy bleeding continued or worsened. In untreated controls, 22 out of 32 patients (68.8%) continued suffering from dysfunctional bleeding and abdominal pain associated with uterine fibroids and requested another mode of therapy. The changes in the volume of myomas between the experimental and control group were statistically significant (p = 0.044). Conclusion: Use of low-dose hormonal contraceptives with progestin dominancy can lead to significant reduction in myoma volume.