Current approaches to the treatment of endometrial hyperplasia in women with uterine leiomyoma

• Main Authors: Potapov V.A., Donskaya Yu.V., Medvediev M.V.
• Format: Article
• Language: English
• Published: SE "Dnipropetrovsk medical academy of Health Ministry of Ukraine" 2014-09-01
• Series: Medičnì Perspektivi
• Subjects: uterine leiomyoma; endometrial hyperplasia; myomectomy; conservative treatment; GnRH agonists; OCPs
• Online Access: http://medpers.dsma.dp.ua/issues/2014/N3/23-29.pdf

The study involved 155 women, of which 30 healthy women were in the control group. 125 women with uterine leiomyomas and endometrial hyperplasia constituted the main groups. In all women with uterine leiomyoma myomectomy was performed. Further treatment included randomized study of a new regimen of GnRH agonists together with COCs after myomectomy using comparison techniques: monotherapy with a-GnRH, progestins (dydrogesterone) or COCs. The treatment using different medication regimens of endometrial hyperplasia after myomectomy convincingly demonstrated significantly greater efficacy of GnRH-a and COCs com¬bination in reducing frequency of symptoms of these diseases, volume of menstrual blood loss and improvement quality of life through the entire observation period. Greater efficacy of COCs and a-GnRH combination, to our opinion, is associated with a greater degree of suppression of cell proliferation and angiogenesis as a result of local (COCs), and systemic effects (a-GnRH).Thus, the proposed method of adjuvant therapy after myomectomy for women with associated endometrial hyperplasia has significant clinical benefits with minimal impact on bone mineral density and other menopausal signs caused by a-GnRH monotherapy.