effect of a non-steroidal aromatase inhibitor anastrazole on symptomatic uterine leiomyomata in premenopausal women

ABSTRACT

To evaluate the effect of a non-steroidal aromatase inhibitor anastrazoIe on symptomatic uterine leiomyomata in premenopausal women. This was a prospective intervention study carried out at Kasr El-Aini hospital. 48 premenopausal women with symptomatic uterine leiomyomata were enrolled and treated with anastruzole 1mg daily for three cycles of 28 day each. The effect of treatment was evaluated on leiomyoma and uterine volumes, endometrial thickness, gonadotrophins, estradiol and hematocrite levels, menstrual pattern, severity of leiomyoma-related symptoms and adverse effects. The effects of leiomyoma location, size and age of participants on tumor volume changes were evaluated. 40 women with 52 Ieiomyomata finished the study. Anastrazole resulted in a mean 52% reduction of leiomyoma volume [173.7 to 83.3ml, p<0.00.], a 29% reduction in total uterine volumes [290.2 to 205. 1ml, p<0.001] and an increase of the hematocrite levels [34.3% to 38.1%, p<0.001] at the end of treatment. Leiomyoma location had no significant effect on volume decrease. Leiomyoma volume decreased in women aged older than 40 years [p<0.001], whereas no significant difference was found in women younger than 40. The size of large Ieiomyomata [greater than 50mm] decreased significantly [p<0.001], Less difference was observed in small leiomyomata [50mm or less] [p=0.01]. No difference were detected in hormonal status. Aromatase inhibitor, Anastrazol was useful in the management of symptomatic Leiomyoma without causing serious hypoestrogenic adverse effects. Further clinical trials are warranted regarding long-term administration