Uterine Fibroid Tumor Treatment Medication

No medication cures uterine fibroids, but a number of drugs are available to control symptoms. Medication therapy covers a broad range: from pain management to pre-operative shrinking of the fibroid.

Symptom Management: NSAIDs and Birth Control Pills

Over the counter NSAIDs (non-steroidal anti-inflammatory drugs) may be used to treat mild pain symptoms. Severe symptoms require more aggressive intervention than the use of NSAIDs, but these pain relief medications work very well for low-grade pain.

Birth control pills with small amounts of estrogen have been used as a rudimentary form of hormone therapy. The “pill” is used to reduce heavy menstrual bleeding. While birth control pills provide a measure of symptom relief, they have no effect on leiomyoma growth rates.

Lupron and Other GnRH Agonists

Hormone therapy for fibroids is often provided with gonadotropin releasing hormone agonists (GnRH agonists), such as Lupron Depot®, Synarel® and Depo Provera®. Of the three, Lupron is most often used in the United States. GnRH agonists limit estrogen activity, creating an artificial state of menopause (called “medical menopause”). Lack of estrogen slows leiomyoma growth rates and causes the neoplasms to shrink.

Lupron and other GnRH agonists are usually administered by injection every one to three months. Due to the high rate of associated side effects, hormone therapy is intended for short-term treatment: six months is generally the limit. The drugs are used to reduce severe symptoms, and to shrink leiomyoma prior to surgery.

Side Effects of GnRH Agonists

Lupron and other GnRH agonists produce a variety of side effects. Most side effects resemble menopause: hot flashes, mood changes, and flushing are all common. In addition to menopause-like symptoms, GnRH agonists also cause rapid bone loss. If treatment is continued long-term, osteoporosis may result.

Hormone therapy is also restricted by a rebound effect. Six months after GnRH treatment ends, many fibroids grow back to their original size. This regrowth can be accompanied by a worsening of uterine bleeding and pain.

RU-486: the “Abortion Pill”

Studies into the effects of RU-486, also called the “abortion pill,” suggest that the drug may have a limiting effect on fibroid growth. Researchers at the University of Rochester in New York discovered that after six months of low dose treatment with RU-486 (mifepristone), women reported fewer fibroid symptoms, and the fibroid tumors shrank. RU-486 blocks progesterone receptors in the uterus, which hinders leiomyoma growth.

In high doses, the abortion pill can cause hot flashes, but the study indicated that doses as small as 5 mg a day reduced fibroid size. The hope is that RU-486 could be used to reduce fibroid size before surgery, or control leiomyoma growth without surgery until menopause, when fibroids usually shrink due to naturally dropping estrogen levels.