Low Dose Mifepristone in the Management of Uterine Fibroids

Background: Uterine fibroids are the most common benign smooth muscle tumors of the female reproductivesystem. It accounts for one-third of all gynecological hospital admissions and is the most common indication(making up approximately 40%) for hysterectomy in premenopausal women. Mifepristone (RU 486) effectivelyreduces menorrhagia and other fibroid-related symptoms, and its size.Objectives: To study the effect of low dose Mifepristone for 3 months on improvement of fibroid relatedsymptoms and its size.Materials and Methods: This was a hospital-based prospective cross-sectional study which was conducted inthe Department of Obstetrics and Gynecology in Silchar Medical College and Hospital, Assam. 246 womenwere enrolled and divided into two groups. Patients in Group 1 received Tab Tranexamic acid (500 mg) and TabMefenamic acid (500 mg) thrice daily during menstrual bleeding for a period of 3 months. Patients in Group 2received Tab Mifepristone 25 mg daily for 3 months.Results: Mean PBAC score reduced by 96.03%, Mean Numeric Pain Rating Scale Score for dysmenorrheareduced by 82.87%, fibroid area reduced by 34% and hemoglobin concentration increased by 10% at 3 monthsin Group 2. These changes in Group 2 were found to be statistically significant (p<0.001) compared to Group 1.Conclusion: Mifepristone has proven to be safe and effective as compared to treatment with tranexamic acidand mefenamic acid for management of uterine fibroids