Second Chapter
Dr. Álvaro Monterrosa Castro, MD
Fibroids
Uterine fibroids are benign tumors that form from the myometrium, are common, reach very different sizes and are a frequent cause of hospitalization (81).
They are the most common pelvic tumors in women. The high peaks of endogenous estrogens normally circulating during the menstrual cycle act on receptors in the myometrium and are considered to be factors related to the formation of uterine fibroids.
These high levels of endogenous estrogens could be avoided with the simultaneous use of estrogen and progestin present in microdose combined oral contraceptives, which would reduce the incidence of uterine fibroids by 17% for every five years of use (117). The protective effect seems to be limited to the time of use of the method.
In the study conducted by the Oxford Planned Parenthood Association and published by Ross et al, the analysis of 535 women with fibroids revealed a decreasing risk trend, compared to the risk for women who had never used oral contraceptives. .
The relative risk of fibroids related to the period of use, determined in the study, was: 1 to 24 months 1.04, 25 to 48 months 0.80, 46 to 96 months 0.79, 97 to 144 months 0.73, 145 and more months 0.54. P = 0.015 in the linear trend of the logistic model (118).
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In the Italian study (119) published in 1999:
A 70% reduction in the risk of fibroids among pill users was demonstrated. OR: 0.3 (CI: 0.2 – 0.6). For past users, the risk of uterine fibroids also decreased as the duration of use of the contraceptive pill increased, remaining at a 50% risk reduction if the combined oral contraceptive was used for seven or more years. OR: 0.5 (CI: 0.3 – 0.9).
Contraceptives are not indicated in the medical treatment of uterine fibroids. Friedman and Thomas (75) in women with uterine myomatosis, observed that microdose oral contraceptives do not produce significant changes, without increase or decrease, in uterine size, when evaluated by clinical examination and ultrasound.
They note having observed a decrease in the duration of menstrual flow and an increase in hematocrit.
Dr. Álvaro Monterrosa Castro, MD
