SEQUENTIAL GN-RH SUPERAGONIST AND MEDROXYPROGESTERONE ACETATE TREATMENT OF UTERINE LEIOMYOMATA

A group of 48 women with symptomatic leiomyomata were treated during 6 months with the short-acting Gn-RH superagonist analog buserelin. The first (group C) was followed up for an additional six months of no medication. The second (group M) was treated for 6 additional months with medroxyprogesterone acetate (MPA) at doses decreasing from 200 to 25 mg/day. Buserelin therapy significantly decreased uterine size (P < 0.001) in all patients, the average final volume being 48.5% of the original (from 262 ± 147 ml to 127 ± 85.4 ml). In group C there was a significant (P < 0.001) re-growth during the post-treatment observation period (from 120 ± 81.0 ml to 198 ± 77.2 ml); a significant (P < 0.01) re-growth was also observed in group M during MPA medication (from 132 ± 77.2 ml to 170 ± 96.0 ml). The agonist had also a marked effect on fibroids: on average they decreased from 75.1 ± 74.3 ml to 24.7 ± 23.3 ml (P < 0.025). In group C during the post-buserelin period of observation without treatment, there was a significant re-growth from 23.7 ± 21.6 ml to 47.7 ± 27.5 ml (P < 0.001), whereas in group M treatment with MPA prevented any significant re-growth (from 25.6 ± 24.8 to 30.6 ± 32.9 ml; P > 0.3).