Comparative Study of Different Dosages of Goserelin in Size Reduction of Myomatous Uteri

Abstract

Study Objective

To compare uterine size reduction obtained with three monthly subcutaneous injections of 3.6 mg of goserelin versus a single subcutaneous injection of 10.8 mg.

Design

Prospective, randomized clinical trial (Canadian Task Force classification I).

Setting

Department of Gynecology and Obstetrics at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.

Patients

Forty-five premenopausal women with uterine leiomyomas and uterine size greater than 600 cm³ randomized to one of two groups.

Intervention:

Group A: 23 women received three monthly subcutaneous 3.6-mg doses of goserelin. Group B: 22 women received a single subcutaneous injection of 10.8 mg of goserelin. Follicle-stimulating hormone (FSH), estradiol, and hemoglobin levels were measured monthly. After 3 months, uterine size was determined by transvaginal and/or abdominal ultrasound.

Measurements and Main Results

In group A, mean reduction of uterine size was 43% (426 cm³) at the end of treatment. In Group B, mean reduction of uterine size was 54% (494 cm³). Serum levels of FSH and estradiol were in postmenopausal range during treatment. Hemoglobin level improvement was equivalent in both groups.

Conclusion

Use of single injection of 10.8 mg of goserelin promoted significantly greater reduction in uterine size than three monthly 3.6-mg injections in patients with voluminous uterine leiomyomas.