'Morning-After' Pill May Be New Option to Treat Painful Fibroids 02/02/12
WEDNESDAY, Feb. 1 (HealthDay News) -- The morning-after pill may
help shrink painful fibroids and relieve excessive bleeding, new
Fibroids are benign tumors that form on the wall of a woman's
uterus; as many as 80 percent of all women may have fibroids. Many
cause no symptoms, but one in four women experiences symptoms that
are severe enough to require treatment, according to the National
Uterine Fibroids Foundation. Symptoms may include heavy periods,
anemia, bloating, constipation, infertility and miscarriage.
Treatment may involve surgery to remove the uterus and/or hormone
treatments such as Lupron (leuprolide) or oral contraceptives.
Now, two new studies in the
New England Journal of Medicine suggest that the
'morning-after' pill Ella (ulipristal) works just as well as Lupron
in treating fibroid-linked uterine bleeding, with less risk of hot
flashes. The new studies were funded by PregLem, which markets a
form of ulipristal acetate called Esmya.
The drug, used as an emergency contraceptive to prevent
pregnancy when taken within five days of unprotected sex, lowers
levels of the hormone progesterone, which feeds fibroids.
In one study, women with fibroids who took 5 milligrams (mg) or
10 mg of Ella for 13 weeks had less bleeding and their fibroid
shrank when compared to women who took a placebo. A second study
showed that women who took either dose of Ella were less likely to
have hot flashes than women who received injections of Lupron. Both
studies were conducted by researchers from the Cliniques
Universitaires Saint-Luc Catholic University of Louvain, in
"Clearly women with fibroids need more alternatives to hysterectomy, especially as they pursue educations and working and not having children until after they have developed fibroids," said Dr. Elizabeth Stewart, a reproductive endocrinologist at the Mayo Clinic in Rochester, Minn. who wrote an editorial accompanying the new studies. "Surgical solutions are not ideal, so we need more medical treatments. This study suggested that these drugs work equivalently to our standard medical treatment for fibroids and what I am hoping is that future studies will confirm this. Women could then take a drug like this for three months and then come off."
One of the concerns with Ella was that the medication caused
worrisome, potentially precancerous changes in the lining of the
uterus. These changes appear to be reversible, Stewart said. "If
you can reverse these changes and keep your symptoms under control,
this treatment can be used in the long term."
Dr. Micheline Chu, director of the recurrent pregnancy loss
program at the Center for Human Reproduction at North Shore
University Hospital in Manhasset, N.Y., said there may be a role
for this pill in certain women with fibroids. Lupron puts people in
to a premature medical menopause, can't be taken indefinitely due
to side effects, and when you stop talking it, the fibroids grow
back. Chu often prescribes Lupron to women to reduce the size of
their fibroid before surgery. "This pill is better for the type of
person who is done having kids and is bothered by fibroids or
bleeding," she said. "It can offer a long-term fix for these
Dr. Elizabeth Poynor, a gynecologic oncologist and pelvic
surgeon at Lenox Hill Hospital in New York City, said that a new
way to treat fibroids is needed. "A lot of our medications don't
work so well for fibroids, so I see a great role for this
medication," she said. "It is a potential long-term treatment for
women who want to avoid surgery."
Find out about fibroids at the
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