What is the recommended progesterone dose for the treatment of uterine leiomyomas (fibroids)?

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From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

The recommended progesterone dose for the treatment of uterine leiomyomas (fibroids) is 50 mg of mifepristone given weekly, as this regimen has been shown to be efficacious and acceptable for the treatment of symptomatic leiomyoma, especially in a select group of patients 1.

Key Considerations

  • The treatment duration is usually 6 months, but can be longer if needed.
  • Mifepristone helps shrink fibroids by counteracting estrogen's growth-promoting effects on fibroid tissue.
  • It also helps regulate menstrual bleeding, which is often heavy in women with fibroids.
  • Side effects may include a transient rise in liver transaminases, which typically revert to normal after stopping treatment.

Important Notes

  • Before starting treatment, consult a gynecologist for proper diagnosis and to rule out other conditions.
  • Regular follow-ups are important to monitor fibroid size and symptoms.
  • Progesterone therapy may be combined with other treatments like GnRH agonists or used as a standalone option, depending on individual circumstances.
  • The use of mifepristone as a primary medical therapy is limited due to recurrence of fibroid after stopping treatment, but it is useful for perimenopausal women whose myoma would regress after menopause, and younger infertile patients with small-size deep intramural myomas not easily accessible to either hysteroscopic or laparoscopic surgery.

Additional Information

  • Other selective progesterone receptor modulators (SPRMs) like ulipristal acetate have also been evaluated for medical treatment of uterine fibroids, but the evidence for their use is still emerging 2.
  • The therapeutic potential of SPRMs for uterine fibroids is promising, but more research is needed to fully understand their efficacy and safety 3, 4.

References

Research

Efficacy of Use of Long-Term, Low-Dose Mifepristone for the Treatment of Fibroids.

Journal of obstetrics and gynaecology of India, 2016

Research

Selective progesterone receptor modulators (SPRMs) for uterine fibroids.

The Cochrane database of systematic reviews, 2017

Research

Preoperative medical therapy before surgery for uterine fibroids.

The Cochrane database of systematic reviews, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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