title: A randomized study of the effects of tibolone and transdermal estrogen replacement therapy in postmenopausal women with uterine myomas.
abstract: OBJECTIVE
  To evaluate the effects of two types of hormone replacement therapy, an estrogen-progestin combination and tibolone, on uterine myomas in menopausal women.
  
  
  METHODS
  Thirty-eight menopausal women with one or more uterine myomas were randomized to treatment with a transdermal system continuously releasing estradiol 50 microg/day combined with oral medroxyprogesterone acetate (MPA) 10 mg/day for 12 days/month or tibolone tablets 2.5 mg/day. The scheduled duration of both treatments was 12 months. Physical examination and abdominal/transvaginal ultrasonography were performed before entering the study and at 3, 6 and 12 months of treatment. At each ultrasonography the overall uterine volume was determined as well as the size of each myoma and the endometrial thickness and characteristics.
  
  
  RESULTS
  No statistically significant difference was detected between the two groups at any time during treatment. However, within-group analysis showed a significant increase of uterine volume and of myoma number and size in the estrogen-progestin group, whereas no such increase occurred in the patients treated with tibolone. Also, the mean endometrium width increased significantly from baseline to the end of treatment in the estrogen-progestin group, but not in the tibolone group.
  
  
  CONCLUSIONS
  Tibolone seems a valid alternative in menopausal patients with uterine myomas as it provides adequate relief from menopausal symptoms and avoids volume increase of the uterus and myomas.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Verona, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Fedele
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: R
authors.initials: R
authors.lastname: Raffaelli
authors.forename: G
authors.initials: G
authors.lastname: Zanconato
mesh_terms: D000279:Administration, Cutaneous; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy*; D008525:Medroxyprogesterone / Q000008:administration & dosage; D008875:Middle Aged; D009652:Norpregnenes / Q000008:administration & dosage*; D045167:Progesterone Congeners / Q000008:administration & dosage; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000188:drug therapy*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D009652:Norpregnenes; D045167:Progesterone Congeners; D004958:Estradiol; C027385:tibolone; D008525:Medroxyprogesterone