UPA treatment for uterine fibroids

This is an automatically translated article.

The article was professionally consulted with Master, Doctor Trinh Thi Thanh Huyen - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital.

1. What are uterine fibroids?

Uterine fibroids form when abnormal growths in or on the uterus. This is a benign tumor originating from the smooth muscle of the uterus, most often in women of childbearing age 35 to 55 years old. Uterine fibroids are very variable in size and are usually less than 15cm in size.
There are many causes of uterine fibroids such as:
Abortion multiple times: Abortion can cause damage to the uterine lining IUD insertion: IUD insertion procedure if not sterile will cause inadvertently introduce harmful bacteria into the uterus and cause uterine fibroids Hormonal disorders: Decreased estrogen is also the cause of uterine fibroids, common in premenopausal women . Stress, prolonged stress: Is the cause of hormonal changes, stimulating the secretion of estrogen. If the condition persists, it will be the cause of uterine fibroids. Uterine ulcers without treatment Gynecological inflammatory diseases: Gynecological inflammatory diseases will cause the uterine lining to proliferate excessively, especially the disease lasts a long time and recurs many times. As the lining thickens, fibroids form outside the uterus.

Symptoms that appear in patients with uterine fibroids include:
Menstrual cycle disturbances Back pain, abdominal pain Painful urination, difficulty urinating and frequent urination Constipation Pain during sex, burning in the area private

2. What is UPA treatment for uterine fibroids?

UPA treatment for uterine fibroids is also known as medical therapy. This is a common treatment in cases of uterine fibroids. The advantages of UPA treatment include:
UPA can be applied to patients before surgery, with the aim of shrinking uterine fibroids and reducing anemia. UPA can be used for a long time. Medical treatment can replace surgery, especially for women who are approaching menopause, still want to have children, and medical methods meet the desire to keep the uterus in a safe way. safe for most patients. UPA treatment for uterine fibroids is the use of drugs that modulate selected progesterone receptors. Select drug Ulipristal Acetate with the aim of increasing cell death by concentration and reducing the background tissue in the tumor, so there is less recurrence after stopping the drug. Ulipristal Acetate in the treatment of uterine fibroids has no effect on the normal muscle fibers of the tumor, and does not inhibit the hypothalamic and ovarian axis.

3. Subjects applying the UPA treatment method

UPA treatment for uterine fibroids is indicated by the doctor to be applied in the following cases:
Patients with uterine fibroids have no symptoms: Patients with uterine fibroids have not yet shown any symptoms. No treatment is needed, but continue to monitor abnormalities and examine whether the tumor is pressing on organs. For women who have entered the perimenopausal stage, when the tumor has a rapid growth in size, special monitoring is required to progress to malignancy. Patients with uterine fibroids have symptoms of severe abnormal uterine bleeding or compression: common in older women. If the patient has type L0, L1, L2 fibroids, medical treatment to stop the bleeding. After that, surgery, hysterectomy, and tumor removal will be considered for those who have had enough children and do not intend to have children. In cases where the patient needs to become pregnant, an IUD containing a progestin can be inserted to prevent uterine adhesions and symptom recurrence.

4. UPA treatment regimen for uterine fibroids

4.1 Steps to take Step 1:
Overall examination of the patient Scan, test liver function before using UPA In case the patient has AST and/or ALT increase 2 times higher than normal value, do not give use medical treatment

Step 2:
Take UPA 5 mg, 1 tablet per day x 3 months. Once on treatment, still conduct liver function tests once a month, if AST and/or ALT increase 2 times, discontinue use. After 13 weeks, discontinue treatment and re-test liver function after about 2-3 weeks. Step 3:
Check normal liver function, continue taking the second course after taking 2 months off the drug. Dosage and monitoring as step 2 Step 4:
After re-examination, if necessary, the patient can take 4-8 more times. Two sessions 2 months apart The following sessions only need to be tested before and after each course of treatment 4.2 Notes when applying the UPA treatment protocol Some notes when applying the UPA treatment regimen:
Treatment of fibroids UPA supply has a great influence on liver function, so it is necessary to check liver function tests before applying treatment. Some side effects during treatment: Headache, abdominal pain, chest tightness after 1-2 days of starting the drug. UPA treatment regimen for uterine fibroids reduces the indication for hysterectomy by about 50% in the treatment cases. After treatment, the patient can continue to become pregnant and give birth.

In summary, the treatment of uterine fibroids with UPA is a medical treatment using drugs that modulate the progesterone receptor of choice. Select drug Ulipristal Acetate with the aim of increasing cell death by concentration and reducing the background tissue in the tumor, so there is less recurrence after stopping the drug. This is a minimally invasive treatment, which helps the patient maintain the ability to become pregnant and have children.
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