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January 22, 2020

New medication may be an alternative to surgery for some women with fibroids

Hormone-blocking pill reduces menstrual bleeding caused by fibroids, Jefferson Health doctor finds

A new medication may help prevent heavy menstrual bleeding in women with uterine fibroids, potentially offering them an alternative to extensive surgery.

A study found that an oral hormone-blocking pill called elagolix suppresses hormone production, reducing both the fibroids' size and associated bleeding. The study, led by a researcher at Thomas Jefferson University, was published Wednesday in the New England Journal of Medicine. 

Roughly 50% of women who have uterine fibroids experience heavy menstrual bleeding. Surgery is the most common treatment. Some women have their uterus completely removed while others have the fibroid removed and the uterus repaired. Both procedures are considered extensive. 

Long-acting hormone injections also can reduce symptoms, but side effects can be significant and take months to go away.

The new pill could offer women another treatment option, said Dr. William Schalff, chair of the department of obstetrics and gynecology at Jefferson's Sidney Kimmel Medical College, who led the study.

“The potential value of an oral, easily reversible medication that can be combined with low-dose hormonal 'add back' to reduce heavy menstrual bleeding while avoiding problematic symptoms and side effects could be a major step forward,” Schlaff said.

The study involved 790 women, ages 18 to 51, who had heavy menstrual bleeding due to fibroids. Researchers placed them in three groups. 

The first received the pill to reduce the production of estrogen and progesterone hormones. A second received the drug alongside a small dose of estrogen and progestin. Researchers wanted to see whether the hormone supplements would reduce the drug's side effects, which include hot flashes and bone loss. A third group received a placebo. 

Researchers found that more than 80% of the women who only received the drug saw their bleeding reduced by at least 50%. Additionally, 72% of the women who received the drug with the hormone supplements saw their bleeding reduced by at least 50%.

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