Menopausal changes in the myometrium: An investigation using a GnRH agonist model

Thirty-four premenopausal women were randomized to receive 3.75 mg of leupr orelin acetate depot or placebo for 8 weeks before hysterectomy. Postoperat ively, the myometrium was examined by two independent pathologists and the pathologic features were graded. Computer analysis was used to assess myome trial cellularity and arterial wall structure (on hematoxylin and eosin-sta ined sections) and vascularity (on sections immunostained for Factor VIII-r elated antigen). The cellularity of the gonadotrophin-releasing hormone ago nist-treated myometrium was higher than the controls with less stromal edem a. Focal myometrial hyalinization was present in a minority of cases, all i n the gonadotrophin-releasing hormone agonist-treated cases. The arteries i n the gonadotrophin-releasing hormone agonist-treated uteri underwent atrop hy of the tunica media and had significantly more perivascular fibrosis. Th e number of vessels per 100 myocytes also was decreased. Hypoestrinism seco ndary to leuprorelin treatment leads to myocyte atrophy, decreased stromal edema, atrophy of the arcuate arteries, and decreased myometrial vascularit y.