Characteristics of menstrual function and blood test parameters in women with uterine fibroids using multiphasic and monophasic combined hormonal contraceptives

BACKGROUND: In some cases, women with uterine fibroids have heavy menstrual bleeding and dysmenorrhea. Combined hormonal contraceptives are used both for contraception and to alleviate the clinical manifestations of uterine fibroids that do not require surgical treatment. Publications on the effect of combined hormonal contraceptives on the clinical course of uterine fibroids are rare. AIM: The aim of this study was to evaluate the characteristics of menstrual function, as well as clinical and biochemical blood test parameters, blood lipid spectrum and hemostatic screening test parameters in dynamics in women with uterine fibroids using low-dose multiphasic and monophasic combined hormonal contraceptives with ethinyl estradiol. MATERIALS AND METHODS: This study included 148 women, out of whom there were 118 patients with uterine fibroids without indications for surgical treatment [54 patients used multiphasic (ethinyl estradiol ans desogestrel) and monophasic (ethinyl estradiol and various gestagens) combined hormonal contraceptives, 64 patients did not] and 30 healthy participants using combined hormonal contraceptives with ethinyl estradiol. At baseline, after six and 12 months, the study participants were assessed for the duration, volume, and painfulness or painlessness (visual analogue scale, McGill pain questionnaire) of menstrual blood loss, as well as laboratory examination parameters. RESULTS: In women with uterine fibroids using various combined hormonal contraceptives (n = 54), a decrease in the duration (5.6 ± 1.2, 4.1 ± 1.0, and 4.1 ± 1.2 of a day respectively; p 0.05) and volume of menstrual bleeding was noted after 6 and 12 months. 6 of 16 patients with uterine fibroids and heavy menstrual bleeding used combined hormonal contraceptives (2 patients used multiphasic contraceptives, and 4 others monophasic ones). In these 6 women, normal hemoglobin (124–132 g/l) and ferritin (35.4–42.4 μg/l) levels were recorded after 12 months. In patients with uterine fibroids, a reduction in dysmenorrhea or a decrease in its intensity was observed with the use of multiphasic (n = 7; 5.1 ± 1.5, 2.0 ± 0.7, and 1.6 ± 0.5 of a point, respectively) and monophasic (n = 2; 4.6 ± 1.2, 3.7 ± 1.1, and 3.0 ± 0.4 of a point, respectively) combined hormonal contraceptives (p 0.05). No changes were recorded in the initially normal parameters of biochemical blood analysis, lipidogram and coagulogram in the study participants. CONCLUSIONS: The use of multi- and monophasic combined hormonal contraceptives with ethinyl estradiol in patients with uterine fibroids leads to a decrease in the duration and volume of menstrual blood loss. It helps maintain normal levels of hemoglobin and ferritin and reduce the frequency and intensity of dysmenorrhea associated with uterine fibroids. Apart from that, it does not lead to changes in the parameters of biochemical blood analysis, blood lipid spectrum and hemostatic screening in the absence of contraindications to the use these drugs.