Rozenberg Serge, Praet Julie, Pazzaglia Eliza, Gilles Christine, Manigart Yannick, Vandromme Jean
Department of Obstetrics & Gynaecology, CHU Saint-Pierre, Université Libre de Buxelles, Vrije Universiteit Brussel, Brussels, Belgium.
Aust N Z J Obstet Gynaecol. 2017 Aug;57(4):393-399. doi: 10.1111/ajo.12641. Epub 2017 Jun 1.
This review discusses the development of selective progestin receptor modulators (SPRMs) for use in women's health and specifically the use of ulipristal acetate (UPA) as emergency contraception (EC) and as a treatment for symptomatic fibroids in women who want to preserve their fertility or avoid a hysterectomy. As an EC, UPA 30 mg should be recommended for women, within 102 h of unprotected intercourse. As a treatment of fibroids, UPA (5 mg daily dose) should be administered for periods of three months as a pre-surgical strategy, reducing bleeding and fibroid size and facilitating surgery. A proportion of these patients may even avoid surgery. Future developments will demonstrate whether UPA can be used for other indications such as endometriosis and breast cancer prevention or treatment.
本综述讨论了用于女性健康的选择性孕激素受体调节剂（SPRMs）的发展，特别是醋酸乌利司他（UPA）作为紧急避孕（EC）以及用于希望保留生育能力或避免子宫切除术的有症状子宫肌瘤女性的治疗用途。作为紧急避孕药，应在无保护性交102小时内为女性推荐30毫克UPA。作为子宫肌瘤的治疗药物，应采用术前策略，给予UPA（每日剂量5毫克）三个月，以减少出血和肌瘤大小并便于手术。这些患者中有一部分甚至可能避免手术。未来的发展将证明UPA是否可用于其他适应症，如子宫内膜异位症以及乳腺癌的预防或治疗。
