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

Parsanezhad, Mohammad Ebrahim; Azmoon, Mina; Alborzi, Saeed; Rajaeefard, Abdolreza; Zarei, Afsoon; Kazerooni, Talieh; Frank, V.; Schmidt, Ernst Hienrich

doi:10.1016/j.fertnstert.2008.09.064

Cited by 138 publications

(91 citation statements)

References 49 publications

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“…In the present study our patients revealed an average reduction of 57.5 % in myoma volume in response to leuprolide acetae (1.8mg/month). The results are in agreement with those of previous studies (Levy, 2008;Parker, 2007;Parsanezhad et al, 2010;Sankaran & Manyonda, 2008). The GnRHa treatment is often associated with so-called ovarian defect symptoms, including vasomotor instability, vaginal dryness, and significant bone loss, which preclude the long-term use of this compound (Levy, 2008;Parker, 2007;Sankaran & Manyonda, 2008).…”

Section: Discussionsupporting

confidence: 91%

Sequential Management with Gonadotropin-Releasing Hormone Agonist and Dienogest of Endometriosis-Associated Uterine Myoma and Adenomyosis

Imai¹,

Matsunami²,

Ichigo³

2012

Endometriosis - Basic Concepts and Current Research Trends

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Section: Discussionsupporting

confidence: 91%

Sequential Management with Gonadotropin-Releasing Hormone Agonist and Dienogest of Endometriosis-Associated Uterine Myoma and Adenomyosis

Imai¹,

Matsunami²,

Ichigo³

2012

Endometriosis - Basic Concepts and Current Research Trends

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“…In a recent randomized controlled trial, letrozole, 2.5 mg, was utilized for 3 months and compared with triptorelin monthly. At the end of 3 months, the decrease in fibroid size was similar for both groups [23], but the main side effect of hot flashes was not seen in women utilizing letrozole. Further evaluation is warranted, but this medical treatment is truly promising.…”

Section: Medical Interventionsmentioning

confidence: 75%

When Should Uterine Fibroids Be Treated?

Pritts¹,

Olive²

2012

Curr Obstet Gynecol Rep

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Fibroids are a common disorder of women, but in general, are best left untreated unless they are significantly symptomatic or an imminent health hazard. When treatment is needed, surgery remains the gold standard. For fertility, fibroids that impinge upon the uterine cavity should be removed to increase future pregnancy rates. There is no evidence that myomectomy for intramural fibroids, even those as large as 6 cm, increases fertility potential, or improves pregnancy outcome. Prophylactic myomectomy of large fibroids (largest diameter>5 cm) to decrease delivery complications is not recommended because it confers worse outcomes at delivery versus women with these large fibroids in situ. Medical treatment is transient, with most fibroids returning to pretreatment size a few months after treatment is stopped. It may, however, have a place for pretreating women before surgical removal, to treat anemia, or in perimenopausal women. Invasive radiological treatments (eg, uterine artery embolization and magnetic resonance guided ultrasound surgery) are effective for treating fibroids, but must be evaluated further before they can be recommended for women interested in future fertility.

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“…Parsanezhad et al used letrozole in a daily dose of 2.5 mg for 12 weeks and found reduction in leiomyoma volume by 31.7%, 42.71% and 45.6% after 4 weeks, 6 weeks and 12 weeks of treatment with letrozole respectively. 17 Gurates et al reported that at the end of 3 month, letrozole resulted in a mean 46.72% reduction of original uterine leiomyoma volume and mean reduction of original uterine volume by 21.67% whereas Hilario SG et al reported that there was average reduction of uterine volume of 9.32% attaining up to 30% with the use of anastrazole 1 mg/day over 12 weeks. 8,12 This study also demonstrated an increase in the haemoglobin concentration which may be due to an improved menstrual pattern.…”

Section: Discussionmentioning

confidence: 99%

Effects of letrozole on patients with symptomatic leiomyoma in the reproductive age women

Prakash

Pandey

Chawla

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Uterine leiomyoma is a common indication for hysterectomy in India. An effective medical treatment option may reduce hysterectomy associated morbidity. This study was undertaken to evaluate the effect of the Letrozole on patients with symptomatic leiomyoma in the reproductive age women.Methods: Prospective interventional study was conducted on 50 women between 30-45 years of age with menstrual or pressure symptoms on the bowel or urinary system, and having no. Of myoma ≤4 and size of single myoma ≥2 cms in diameter. They received tablet letrozole 5mg/day for 3 month, and effect of the drug on myoma volume and symptomatology were studied. Beside these, effects on uterine volume, ovarian volume, endometrial thickness and side effects of letrozole of any were also studied.Results: Average reduction of myoma volume by 47.68% and uterine volume by 19.58% was seen. Haemoglobin concentration was significantly higher at the end of study. It increased from 9.56g/dl to 10.76g/dl and overall improvement in symptomatology score was observed. Ovarian volume increased significantly from baseline mean volume of 8.18±0.51cm³ to 19.3±0.84cm³ and no significant change in endometrial thickness was observed at the end of 3 month. Sweating, hot flushes, nausea and vomiting were the main adverse effects observed and were self limiting.Conclusions: Letrozole, the aromatase inhibitor resulted in significant volume reduction of the uterus-leiomyoma structure and was effective in controlling the more frequent symptoms of this disorder with fewer side effects.

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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

Cited by 138 publications

References 49 publications

Sequential Management with Gonadotropin-Releasing Hormone Agonist and Dienogest of Endometriosis-Associated Uterine Myoma and Adenomyosis

Sequential Management with Gonadotropin-Releasing Hormone Agonist and Dienogest of Endometriosis-Associated Uterine Myoma and Adenomyosis

When Should Uterine Fibroids Be Treated?

Effects of letrozole on patients with symptomatic leiomyoma in the reproductive age women

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