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February 4, 2003 — Mifepristone, the drug also known as RU-486 used for early medical abortion, may prove to be an effective alternative treatment for fibroids, according to a study in the February issue of Obstetrics & Gynecology.
Researchers at the University of Rochester in New York studied 40 women with large fibroids that caused symptoms such as heavy menstrual bleeding, anemia, pelvic pain, bladder pressure, low back pain and/or painful intercourse. For six months, half of the women took 5mg of mifepristone daily, and the other half took 10mg daily. (Mifepristone is given at much higher doses when used for medical abortion.)
After six months, both groups of women experienced comparable shrinking of their fibroids and subsequent improvement in their symptoms. The fibroids had shrunk to about half their original size at the end of the study. While there were few serious side effects with the use of low-dose mifepristone, some of the women experienced hot flashes, mild elevation of liver enzymes, and simple hyperplasia of the endometrium.
The researchers say that this treatment may be clinically useful in three ways: by shrinking fibroids before surgery to reduce complications; by shrinking fibroids long enough to preserve fertility; and by allowing long-term use to shrink large symptomatic fibroids until menopause is reached, when fibroids typically shrink, thereby avoiding hysterectomy. They note, however, that further study is needed on the long-term safety and efficacy of low-dose mifepristone, some of which is currently underway.
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