A new study suggests that the experimental 'morning after' pill may be the key to freeing millions of women from the misery of uterine fibroids.
The drug, ulipristal acetate (UPA), provides an effective non-surgical treatment for the common womb condition that can lead to pain, heavy periods and infertility, say scientists.
UPA belongs to a relatively new class of drug, the selective progesterone receptor modulators or SPRMs. It is currently used for emergency contraception, and acts by blocking the progesterone receptor and hence ovulation (release of the egg).
Recent research has shown that progesterone also plays a role in the development of uterine fibroids.
"Both the fibroids and the surgical interventions commonly used to treat them can cause significant fertility problems and we wanted to see whether fibroids could shrink and surgery could be avoided by using an SPRM," Dr. Alicia Armstrong said.
In the trials, women aged from 25-50 years with symptomatic uterine fibroids were randomised to receive UPA or placebo once a day for three menstrual cycles.
The researchers found that, out of the 57 patients who it was possible to evaluate for efficacy, 18 received placebo, 20 10mg of UPA per day and 19 20mg per day. Those taking UPA had reduced total fibroid volume, with those taking the higher dose doing better - 14 (70 percent) in the 10mg group and 16 (84 percent) in the 20 mg group. The patients on placebo did significantly less well with only six (33 percent) showing reduction in fibroid volume.
UPA also reduced bleeding compared with placebo and during the third month of treatment 16 (80 percent) of patients taking 10mg daily and 18 (95 percent) on a daily dose of 20mg experienced no menstrual bleeding. At the end of the treatment, patients on the active treatment scored higher in assessment of their quality of life, the severity of their symptoms, their energy levels and mood and their overall concern about the effects of fibroids.
Estradiol levels remained adequate for bone health during treatment in 77 percent, 100 percent and 95 percent of patients in the UPA 10mg and 20mg and placebo groups, respectively, indicating that the action of the ovaries was not impaired, and neither were there any serious side effects
"The results of these trials are convincing and lead us to conclude that UPA is an effective non-invasive treatment for fibroids that can help maintain fertility in women whose only option up to now was to have surgery," Doctor Lynnette Nieman, Principal Investigator on the NIH trials said.
The study has been presented at the 26th annual meeting of the European Society of Human Reproduction and Embryology in Rome.