Uterine fibroid in the premenopause: experience of medication treatment

Abstract

Objectives of the study: to evaluate the effectiveness of the progestogens for the treatment of uterine fibroids (UF) in women in the premenopausal period.
Materials and methods. 42 patients aged 45–50 years with UF were examined. The diagnosis of UF was verified according to clinical and instrumental research methods. The effectiveness of the therapy was evaluated according to clinical and ultrasound examination data before and during the course of treatment. All patients with diagnosed symptomatic UF received progestogen dienogest 2 mg ones a day continuously for a year, with clinical and sonographic control every 3 months.
Results. UF was symptomatic in all examined patients. According to the International Federation of Gynecology and Obstetrics (FIGO) classification system for UF, 42.8% (18) of women had type III–IV nodes, 54.8% (23) had type II–V nodes, and 2.4% (1) of women had type VI nodes. In all patients were 2 or more nodes.
Already after 6 months of therapy, bleeding complaints decreased by more than 8 times, moderate pain syndrome and urination disorders were noted in only one (2.4%) patient. After 12 months, pelvic pain and bladder dysfunction were absent in 100% of cases. One (2.4%) patient had spotting bleeding for 2 days during the 8th month of treatment. After 6 and 12 months of treatment, the size of the endometrium decreased significantly to 3.6–7 and 3.2–4.6 mm, respectively. The total volume of the uterus also underwent positive changes: it decreased by 10–40% in each patient during the course of treatment.
Conclusions. It should be preferred progestogens in the treatment of UF in women aged 45–50 years who wish to preserve the uterus. Therapy with dienogest in a continuous long-term regimen showed high clinical effectiveness, confirmed the active antiproliferative, antiovulatory effect of the drug in the absence of estrogen deficiency symptoms, which is important for this  age group of patients.