1991 Volume 22 Issue 4 Pages 531-540
The present study was undertaken to evaluate the efficacy of daily intranasal administration of a luteinizing hormone-releasing hormone agonist (LHRHa) for 16 weeks in the treatment of uterine leiomyomata. The possibility of employing medicinal therapy that would eliminate the need for surgery in the treatment of leiomyoma and symptoms associated with leiomyoma is described. Thirty-nine patients, aged 45 to 54, were divided into two groups in accordance with responsiveness to LHRHa: 13 patients reached menopause after the LHRHa treatment (menopausal group), whereas resumption of menstruation occurred in 26 patients after cessation of the treatment (menstrual group). The mean age in the menopausal group (50.9±0.7 years) was significantly greater than in the menstrual group (48.3±0.4 years). Although there was no significant difference in the levels of serum LH and estradiol (E_2) and uterine volume before treatment between the two groups, the levels of serum FSH before treatment were significantly higher in the menopausal group than in the menstrual group. The levels of serum LH, FSH and E_2, and uterine volume were suppressed during LHRHa treatment, except for a transient increase in serum LH and E_2 one to two weeks after the treatment. After completion of therapy, serum LH and FSH concentrations returned to pretreatment levels in the menstrual group, whereas those gonadotropins increased significantly in the menopausal group. The serum levels of E2 and uterine volume returned to pretreatment values concomitant with the return of normal ovulation in the menstrual group. In conclusion, intranasal administration of LHRHa was successful in significantly decreasing uterine volume and relieving symptoms in perimenopausal women with leiomyoma. One-third of perimenopausal patients reached menopause after 16 weeks of treatment, thus avoiding the need for surgery.
