Uterine fibroid in the premenopause: experience of medication treatment





uterine fibroids, premenopause, dienogest, medical treatment


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.

Author Biography

О.V. Kravchenko, Higher State Educational Institution of Ukraine “Bukovinian State Medical University”, Chernivtsi

MD, professor, head of Obstetrics, Gynecology and Perinatology Department


  1. Plaksiieva KD, Tatarchuk TF, Kosei NV, et al. Uterine fibroids: synthesis of modern knowledge. Literature review. Reproductive Endocrinology. 2021 May 1–2(63-64):8–18. DOI: 10.18370/2309-4117.2022.63.8-18
  2. Lee SJ, Ko H.S, Na S, et al. Nationwide population-based cohort study of adverse obstetric outcomes in pregnancies with myoma or following myomectomy: retrospective cohort study. BMC Pregnancy Childbirth. 2020 Nov 23;20(1):716. DOI: 10.1186/s12884-020-03406-9
  3. Laughlin-Tommaso SK, Stewart EA. Moving toward individualized medicine for uterine leiomyomas. Obstet Gynecol. 2018 Oct 132(4):961–71. DOI: 10.1097/aog.0000000000002785
  4. Sohn GS, Cho S, Kim YM, et al. Current medical treatment of uterine fibroids. Obstet Gynecol Sci. 2018 Mar 61(2):192–201. DOI: 10.5468/ogs.2018.61.2.192
  5. Simon JA, Catherino W, Segars JH, et al. Ulipristal Acetate for Treatment of Symptomatic Uterine Leiomyomas: A Randomized Controlled Trial. Obstet Gynecol. 2018 Mar 131(3):421–9. DOI: 10.1097/aog.0000000000002462
  6. Kornatska АG, Flaksemberg MA, Chubei, GV, et al. Uterine leiomyoma at women of reproductive age: frequency and structure of concomitant pathology (Retrospective analysis). Reproductive Health of Woman. 2020 5(45):42–7. DOI: 10.30841/2708-8731.5.2021.224496
  7. Kosei NV. Uterine myoma: еtiology and morphogenesis. Reproductive Endocrinology. 2018 Apr 2(40):23–32. DOI: 10.18370/2309-4117.2018.40.23-32
  8. Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: A systematic review. BJOG. 2017 Sep;124:1501–12. DOI: 10.1111/1471-0528.14640
  9. Qin H, Lin Z, Vásquez E, et al. Association between obesity and the risk of uterine fibroids: a systematic review and meta-analysis. J Epidemiol Community Health. 2021 75(2):197–204. DOI: 10.1136/ jech-2019-213364
  10. Kondratiuk VK, Kondratiuk KO, Gasparyan KA, et al. Modern opportunities and prospects for preserving woman’s health. Reproductive Health of Woman. 2022 Jul 29;5(60):19–25. DOI: 10.30841/2708-8731.5.2022.265470
  11. Golyanovskiy OV, Kachur OYu, Budchenko MА, et al. Uterine leiomyoma: modern aspects of clinic, diagnosis and treatment. Reproductive Health of Woman. 2021 Jun 30;5(50):7–18. DOI: 10.30841/2708-8731.5.2021.240017
  12. Kornatska AH, Trokhymovych OV, Chubei GV, et al. Peculiarities of genital tract microbiocenosis and immunological homeostasis in reproductive-age women with uterine leiomyoma. Reproductive Health of Woman. 2021 4(49):99–105. DOI: 10.30841/2708-8731.4.2021.238169
  13. Stewart EA, Lytle BL., Thomas L, et al. The comparing options for management: patient-centered results for uterine fibroids (COMPARE-UF) registry: rationale and design. Am J Obstet Gynecol. 2018 Jul;219(1):95. DOI: 10.1016/j.ajog.2018.05.004
  14. Khaskhachikh DA, Potapov VO. Balloon hydrotamponade of the uterus in the treatment of abnormal uterine bleeding. Grail of Science. 2022 16:491–5. DOI: 10.36074/grail-of-science.17.06.2022.081
  15. Yang Q, Ciebiera M, Bariani MV, et al. Comprehensive Review of Uterine Fibroids: Developmental Origin, Pathogenesis, and Treatment. Endocr Rev. 2022 Jul 13;43(4):678–719. DOI: 10.1210/endrev/bnab039
  16. Potapov VO., Ivakh VI. Trategy for prevention of uterine leiomyoma recurrence in combination with adenomiosis after organ-conserving operations in reproductive aged women. Reprod Endocrinol. 2019 Nov 5(49):12-6. DOI: 10.18370/2309-4117.2019.49.12–16
  17. Antypkin YG, Vdovychenko YP, Graziottin A, et al. Uterine bleedings and quality of woman’s life. Reproductive Endocrinology. 2019 3 (47): 8–12. DOI: http://dx.doi.org/10.18370/2309-4117.2018.47.8-18
  18. Go VAA, Thomas MC, Singh B, et al. A systematic review of the psychosocial impact of fibroids before and after treatment. Am J Obstet Gynecol. 2020 Nov 223(5):674–708. DOI: 10.1016/j.ajog.2020.05.044
  19. Ventskivska I, Proshchunko O, Vitovskyi Ya, Markitanyuk SV. Assessment of the quality of life after hystectomy for uterine fibroids. Health of Woman. 2020 8(154):59–63. DOI: 10.15574/HW.2020.154.59
  20. Proshchenko OM, Ventskivska IB. Influence of hysterectomy due to leiomyoma on woman’s psychological status. Reproductive Health of Woman. 2023;1(64):36–40. DOI: 10.30841/2708-8731.1.2023.276247
  21. Li Z, Maeda D, Kudo-Asabe Y, et al. MED12 is frequently mutated in ovarian and other adnexal leiomyomas. Hum Pathol. 2018 Nov:81:89–95. DOI: 10.1016/j.humpath.2018.06.013
  22. Spyropoulou K, Kosmas I, Tsakiridis I, et al. Myomectomy during pregnancy: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2020 Nov;254:15–24. DOI: 10.1016/j.ejogrb.2020.08.018
  23. da Silva F, Pabalan N, Ekaratcharoenchai N, et al. PROGINS Polymorphism of the Progesterone Receptor Gene and the Susceptibility to Uterine Leiomyomas: A Systematic Review and Meta- Analysis. Genet Test Mol Biomarkers. 2018 May;22(5):295–301. DOI: 10.1089/gtmb.2017.0233
  24. Mlodawska OW, Saini P, Parker JB, et al. Epigenomic and enhancer dysregulation in uterine leiomyomas. Hum Reprod Update. 2022 Jun 30;28(4):518–47. DOI: 10.1093/humupd/dmac008
  25. Lin Y, Wu, RC, Huang, YL, et al. Uterine fibroid-like tumors: spectrum of MR imaging findings and their differential diagnosis. Abdom Radiol (NY). 2022 Jun;47(6):2197–208. DOI: 10.1007/s00261-022-03431-6



How to Cite

Kravchenko О. (2024). Uterine fibroid in the premenopause: experience of medication treatment. REPRODUCTIVE ENDOCRINOLOGY, (71), 53–56. https://doi.org/10.18370/2309-4117.2024.71.53-56



Management of menopause