[Low-dose combination oral contraceptives use in women with uterine leiomyomas].

BACKGROUND

To evaluate the effects of the last generation of oral contraceptives (OC) on uterine leiomyomas.

DESIGN

non-randomized perspective study on the effects of the last generation of oral contraceptives on uterine myomas during 24 months follow-up.

SETTING

III Unit of Obstetrics and Gynecology, University of Bari.

PARTICIPANTS

between 1999 and 2000 a total of 121 asymptomatic women with only one subserous and/or intramural uterine myoma, having diameter pound 25 mm have been recruited. These patients were divided into two groups: the treatment group was composed of 53 women and was treated with last generation pill containing 20 microgram of ethynilestradiol and 150 microgram of desogestrel or 20 microgram of ethynilestradiol and 75 microgram of gestodene, while the control group was composed of 68 women having no hormonal therapy. In both groups the uterine myoma size (evaluated by transvaginal ultrasonography), the duration of menstrual flow and the hematocrit at the time of recruitment, after 12 months and after 24 months were examined.

RESULTS

Forty-eight (90.6%) women belonging to the study group completed 2 years of OC use; only sixty women (88.2%) belonging to the control group completed the study. The use of the last generation oral contraceptives for 2 years didn't increase significantly uterine myomas size; besides after 24 months there was a significant reduction of more than two days of menstrual flow, and a significant increase of two and a half points of hematocrit. On the contrary, in the control group, we found a significant increase of uterine myoma volume, a not significant increase of menses duration and a not significant reduction of hematocrit.

CONCLUSIONS

The prolonged use of the last generation of oral contraceptives does not affect the uterine myomas volume increase and furthermore it produces a significant reduction in the duration of menstrual flow with a significant increase in hematocrit.