Treatment of uterine leiomyomata with a luteinizing hormone-releasing hormone agonist: the possibility of nonsurgical management in selected perimenopausal women.
OBJECTIVE
To evaluate the efficacy of luteinizing hormone-releasing hormone agonist (LH-RH-a) in the treatment of leiomyomata.


METHODS
A retrospective randomized trial.


METHODS
Hospital department of obstetrics and gynecology.


METHODS
Twenty-five women, ages 36 to 54 years with symptomatic uterine leiomyomata, were divided into two groups according to the responsiveness to LH-RH-a: group A patients reached menopause after LH-RH-a, whereas resumption of menstruation occurred within 12 weeks after cessation of therapy in group B.


METHODS
Luteinizing hormone-releasing hormone agonist was administered intranasally three times a day with 150 micrograms insufflation of one spray in each nostril (total dose: 900 micrograms/d).


METHODS
Efficacies of treatment were assessed in terms of uterine volume, hemoglobin concentrations, serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), and bone density during and after treatment.


RESULTS
In both groups, hemoglobin concentrations increased significantly after 16 weeks of treatment. A significant reduction in uterine volume was observed in both groups. After completing therapy, there was no further significant change in uterine volume in group A, whereas uterine volume in group B returned to pretreatment values. Serum LH and FSH concentrations were suppressed during treatment, but those gonadotropins in group A increased significantly up to the menopausal levels after treatment. Serum E2 concentrations in both groups showed consistent suppression by the end of the first treatment cycle. After cessation of therapy, serum E2 levels on group A remained in the castrate range, whereas E2 in group B returned to pretreatment levels, concomitant with the return of normal ovulation.


CONCLUSIONS
Intranasal administration of LH-RH-a was successful in significantly decreasing uterine volume and increasing hemoglobin concentration in premenopausal women with leiomyomata.
Nakamura
Y
Y
Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Tokyo, Japan.
Yoshimura
Y
Y
Yamada
H
H
Ubukata
Y
Y
Ando
M
M
Suzuki
M
M
D000328:Adult; D001842:Bone and Bones / Q000473:pathology; D002064:Buserelin / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy* / Q000473:pathology; D007986:Luteinizing Hormone / Q000097:blood; D008593:Menopause; D008875:Middle Aged; D011897:Random Allocation; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014599:Uterus / Q000473:pathology
D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D002064:Buserelin