Abstract
Background
Uterine myomas are benign tumours affecting 20–40% women. Various medical and surgical
therapeutic options are available but the search for an ideal medical option continues.
Aromatase inhibitors have recently been reported to have a potential role in the management
of oestrogen-dependent conditions like endometriosis and leiomyoma.
Objective
To evaluate the effect of letrozole on uterine myoma size and symptomatology in perimenopausal
women.
Study design
Prospective interventional study conducted on 30 premenopausal women aged between
30 and 55 years with menstrual or pressure symptoms and having a single intrauterine
myoma of size 4 cm or more with or without one or more additional myomata each of size 2 cm or less. They received tablet letrozole 2.5 mg a day for 12 weeks, and the effect of the drug on myoma size and volume and symptomatology
was studied along with the adverse effect profile and patient satisfaction.
Results
The mean myoma size reduced from 5.4 ± 1.3 cm to 4.3 ± 0.9 cm (p < 0.05) and the myoma volume exhibited a reduction of 52.45% (p = 0.00) at the end of 3 months. The symptomatology score showed a significant improvement
that persisted up to 3 months after cessation of therapy. No significant effect was
observed on lipid profile, serum estradiol, progesterone, testosterone and FSH and
LH levels during the therapy. Nausea and hot flushes were the main adverse effects
observed and were self-limiting.
Conclusion
Letrozole significantly reduces myoma size and volume and also improves the associated
symptoms. It has a good adverse effect profile and appears to be a promising medical
option for management of uterine myomas.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of Obstetrics and Gynecology and Reproductive BiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Uterine myomas revisited.Eur J Obstet Gynecol Reprod Biol. 2010; 152: 119-125
- GnRH agonists before surgery for uterine leiomyomas: a review.J Reprod Med. 1996; 41: 415-421
- Danazol administration after gonadotropin releasing hormone analogue reduces rebound of uterine myomas.Hum Reprod. 1997; 12: 357-360
- In situ estrogen synthesized by aromatase P450 in uterine leiomyoma cells promotes cell growth probably via an autocrine/intracrine mechanism.Endocrinology. 2000; 141: 3852-3860
- Aromatase and leiomyoma of the uterus.Semin Reprod Med. 2004; 22: 55-61
- Phase III, multicentre, double-blind, randomized study of letrozole, an aromatase inhibitor, for advanced breast cancer versus megestrol acetate.J Clin Oncol. 2001; 19: 3357-3366
- The minimal effective exemestane dose for endocrine activity in advanced breast cancer.Eur J Cancer. 1997; 33: 587-591
- Risks and benefits of aromatase inhibitors in postmenopausal breast cancer.Drug Saf. 1999; 21: 297-309
- Successful treatment of a symptomatic uterine leiomyoma in a premenopausal woman with a non-steroidal aromatase inhibitor.Fertil Steril. 2003; 79: 628-631
- 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. 2010; 74: 192-198
- Action of aromatase inhibitor for treatment of leiomyoma in perimenopausal patients.Fertil Steril. 2009; 91: 240-243
- Estimation of menstrual blood loss volume based on menstrual diary and laboratory data.BMC Women's Health. 2012; : 12-24
- Use of aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate.Fertil Steril. 2001; 75: 305-309
- Endocrine effects of adjuvant letrozole compared with Tamoxifen in hormone-responsive postmenopausal patients with early breast cancer: the HOBOE trial.J Clin Oncol. 2009; 27: 3192-3197
- Effects of aromatase inhibitors letrozole and anastrazole on bone metabolism and steroid hormone levels in intact female rats.Gynecol Endocrinol. 2007; 23: 556-561
- Immediate administration of zoledronic acid reduces aromatase inhibitor-associated bone loss in postmenopausal women with early breast cancer: 12-month analysis of the E-ZO-FAST trial.Clin Breast Cancer. 2012; 12: 40-48
- Aromatase inhibitors and bone health.Curr Opin Obstet Gynecol. 2009; 21: 60-67
Article info
Publication history
Published online: September 26, 2013
Accepted:
September 11,
2013
Received in revised form:
August 14,
2013
Received:
April 17,
2013
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
