Uterine Fibroids and Progestogen Treatment: Lack of Evidence of Its Efficacy: A Review

J Clin Med. 2020 Dec 5;9(12):3948. doi: 10.3390/jcm9123948.

Abstract

Background: The objective of this review is to determine the evidence or, conversely, the absence of evidence regarding the effectiveness of progestogens in treating premenopausal women with uterine fibroids. In particular, the goal is to address recurring questions as to whether they are effective or not for managing symptoms commonly attributed to fibroids.

Methods: A review of the most relevant papers (n = 63) on the efficacy of progesterone and progestogens as medical therapy for uterine fibroids.

Results: Having reviewed the most significant papers on the relationship between uterine fibroids and progesterone/progestogens, it is clear that there is biochemical, histological and clinical evidence that progesterone and progestogens play a critical role in the pathogenesis of myomas.

Conclusion: Since progesterone is already implicated in the pathogenesis of this entity, using progestogens to manage fibroids is like constantly adding fuel to the fire, rendering this treatment ineffective.

Keywords: GnRH agonist; GnRH antagonist; add-back therapy; heavy menstrual bleeding; progesterone; progestogen; uterine fibroids.

Publication types

  • Review