Reduction in the size of a uterine leiomyoma following discontinuation of an estrogen-progestin contraceptive

Gynecol Obstet Invest. 1997;43(4):276-7. doi: 10.1159/000291871.

Abstract

The effects of estrogen-progestin oral contraceptives on the volume of uterine leiomyomata is not well characterized. In this case report, a 45-year-old woman with a symptomatic uterine leiomyoma was observed to have a 47% reduction in myoma volume after discontinuation of an oral contraceptive. The volume of uterine leiomyomata may be influenced by oral contraceptives.

PIP: Although estrogen and progestin influence the volume of uterine leiomyomas, these effects have not been well characterized. Presented is the case of a 45-year-old US woman with right lower quadrant pain and a 5-year history of use of a combined oral contraceptive (OC) containing 0.35 mcg ethinyl estradiol and 0.35 mcg norgestrel. At presentation, the uterus was enlarged to a size corresponding to 12-14 gestational weeks, with a mass at the right fundal margin. Pelvic ultrasonography revealed a large dominant leiomyoma 7.2 x 5.8 x 5.5 cm and several smaller tumors. OC use was discontinued and, 4 months later, the uterus was a size of 8-10 gestational weeks and a single serosal leiomyoma 5.9 x 4.6 x 4.4 cm remained. The leiomyoma volume had decreased by 47% after OC discontinuation, to 63 cu. cm. Pelvic sonography 12 months after OC discontinuation revealed no further changes in myoma volume. In OC users with clinically significant uterine leiomyomas, discontinuation of combined OCs should be considered as a low-risk intervention with the potential to decrease uterine volume.

Publication types

  • Case Reports

MeSH terms

  • Contraceptives, Oral, Combined / adverse effects*
  • Estradiol Congeners / adverse effects
  • Ethinyl Estradiol / adverse effects
  • Female
  • Humans
  • Leiomyoma / pathology*
  • Middle Aged
  • Neoplasms, Hormone-Dependent / pathology*
  • Norgestrel / adverse effects
  • Progesterone Congeners / adverse effects
  • Remission Induction
  • Uterine Neoplasms / pathology*
  • Uterus / drug effects
  • Uterus / pathology

Substances

  • Contraceptives, Oral, Combined
  • Estradiol Congeners
  • Progesterone Congeners
  • Norgestrel
  • Ethinyl Estradiol