Uterine Bleeding Control with Ulipristal Acetate

Ulipristal acetate (UA) is a selective progesterone-receptor modulator, currently approved for pre-operative treatment of moderate-to-severe symptoms caused by uterine leiomyomas in adult women in reproductive age. The posology is 5 mg/day, for 3 months, and it can be repeated once. Retrospective study of 60 women with symptomatic uterine leiomyomas, who were proposed to receive treatment with AU 5 mg/day, during 84 days. Subsequently, they had scheduled appointments every three months (for 12 months), with evaluation of treatment compliance, side effects, and uterine bleeding control. Of the 58 women that completed treatment, abnormal uterine bleeding (AUB) was the main complain in 93,1%. Of the patients whose main complaint was AUB, 88,9% attained amenorrhea during treatment (77,1% within the first month); the average duration of amenorrhea was 3,6 +/- 1,6 months. The menstrual blood flow was subjectively diminished in 33,3% of the patients that never had amenorrhea and in 60,8% of the patients who had at least one month of amenorrhea. Non-serious adverse events occurred in 59,3% of the patients, most of them not needing any therapy. Only 15,5% of the women needed additional therapy for fibroids (55,6% of those had anemia that didn't improve) - 6 hysterectomies and 3 surgical hysteroscopies. UA appears to be an effective and safe treatment in controlling uterine bleeding, with acceptable non-serious adverse events. It induces amenorrhea in most patients and, even after, subjectively diminishes menstrual flow.