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Semin Reprod Med 2004; 22(2): 121-130
DOI: 10.1055/s-2004-828618
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Potential Nonhormonal Therapeutics for Medical Treatment of Leiomyomas

Steven L. Young1 , Ayman Al-Hendy2 , John A. Copland3
  • 1Department of Obstetrics and Gynecology, University of NorthCarolina at Chapel Hill, Chapel Hill, North Carolina
  • 2Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
  • 3Basic Cancer Research Program, Mayo Clinic College of Medicine, Jacksonville, Florida
Further Information

Publication History

Publication Date:
26 May 2004 (online)

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Uterine leiomyomas are a common disorder resulting in significant morbidity for women and substantial economic impact on the health care system. Current therapies include conservative surgery, hysterectomy, and hormonal therapy. Conservative surgical therapy often fails because of recurrence, and hysterectomy dramatically limits reproductive options. Radiologic therapies are associated with considerable risk of morbidity and mortality and are not likely to be compatible with reproduction. Hormonal therapies such as gonadotropin-releasing hormone (GnRH) analogues or progestins with or without estrogen are utilized by many patients, but long-term use of either is often responsible for unacceptable morbidity and hormonal therapies are not compatible with reproduction. Newer hormonal alternatives such as progesterone antagonists and selective agonists as well as “add-back” estrogen therapy in addition to GnRH analogues have been developed and show promise. However, no hormonal therapy that significantly alters estrogen and progesterone production or function is likely to be compatible with reproduction. Thus, it is important to develop novel nonhormonal therapies for medical treatment of leiomyomas. Other laboratories have evaluated pirfenidone, halofuginone, heparin, and interferon-α (IFN-α). Recent work in our laboratory suggests potential use of two additional classes of compounds, thiazolidinediones and tocopherol analogs. The rationale, evidence, and potential for the use of each of these compounds in the treatment of leiomyomas are discussed.

KEYWORDS

Leiomyoma - tocopherol - thiazolidinedione - alpha-tocopherol succinate - apoptosis

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Steven L YoungM.D. Ph.D. 

Associate Professor, Department of Obstetrics and Gynecology (CB# 7570), University of North Carolina at Chapel Hill

Chapel Hill, NC 27599