LEUPROLIDE ACETATE TREATMENT AND MYOMA ARTERIAL SIZE

Objective: To compare the size of arterial vessels in myomas from wome n treated with GnRH agonist (GnRH-a) or given placebo. Methods: Our st udy group included 46 women about to undergo myomectomy or hysterectom y; 30 were treated with leuprolide acetate (3.75 or 7.5 mg) in three m onthly doses, and 16 were given placebo. Arterial diameters of the int ramyomatous vessels were measured using an ocular micrometer on hemato xylin and eosin-stained slides. Results: Clinically and radiologically , the uterine Volume of GnRH-a-treated patients decreased by an averag e of 30%, and the diameter of the largest myoma decreased by 27%. The average diameter of intramyomatous arteries was 24% smaller in GnRH-a subjects compared with those receiving placebo (136 +/- 42 versus 178 +/- 60 mu m, P < .01). In addition, arteriosclerotic changes, includin g intimal and medial fibrosis, were seen more often in the GnRH-a-trea ted subjects (48 versus 25%, P < .05). Conclusion: Intramyomatous arte ries were smaller and more often showed arteriosclerotic changes in le iomyomas removed from women treated with GnRH-a compared with those gi ven placebo. The estrogen deprivation induced by GnRH-a may cause a re lative vasoconstriction of myomatous vessels. Whether this decreased v essel size is the principal contributor to decreased myoma size will r equire further study.