DOES LOW-DOSE COMBINATION ORAL-CONTRACEPTIVE USE AFFECT UTERINE SIZE OR MENSTRUAL FLOW IN PREMENOPAUSAL WOMEN WITH LEIOMYOMAS

Objective: To assess whether low-dose oral contraceptive (OC) use affe cts uterine size or menstrual flow in women with leiomyomas. Methods: Eighty-seven premenopausal women with leiomyomas were enrolled in a 1- year study. Fifty-five women took low-dose monophasic OCs, and 32 took no OCs or other hormonally active medications. Uterine size was asses sed by bimanual and sonographic examinations before and after the stud y. Duration of menstrual flow and hematocrit were also assessed. Resul ts: Fifty (91%) of 55 women completed 1 year of OC use. There was no s ignificant difference in mean uterine size determined by bimanual exam ination or in uterine volume measured by sonography after 12 months of OC use. Likewise, there were no significant changes in these indices among the 32 women who did not take OCs. The mean duration of menstrua l flow decreased significantly, from 5.8 to 4.4 days (P < .01), in the group of women taking OCs. The mean hematocrit increased significantl y, from 35.8 to 37.8% (P = .014), in this group. In contrast, the wome n who did not take OCs had no significant changes in these indices. Co nclusion: In most women with leiomyomas, low-dose OC use provides the noncontraceptive benefit of a reduction in the duration of menstrual f low, with resultant improvement in hematocrit, without increasing uter ine size.