A very interesting group of drugs is known as the GnRH analogues or if you prefer, Gonadotropin Releasing Hormone Analogues. The GnRH analogues are used to create a false menopause by switching off hormones from the brain that stimulate the ovaries to produce the female hormone estrogen, causing the estrogen production to stop.

The advantage of these drugs is that they stop heavy bleeding and, in most women a reduction of size of fibroid tumors by as much as forty to sixty percent.  The GnRH analogues have been used most commonly to make surgical procedures such as removal of fibroids from the uterus safer.  Their particular advantage is they decrease the blood flow through the uterus and fibroids reducing the risk of excessive bleeding when surgery is performed for this condition.  The ability of these drugs to reduce the size of large tumors also may make it easier to remove them. 

The disadvantage of the GnRH analogue is that their effect is reversible.   So although the tumors may shrink very dramatically while being used, when the drug is stopped, the uterus will return to its pre-treatment size over the next six months.

Additional disadvantages of the analogue is the fact that prolonged use will have the same effect as menopause thus exposing women to the risk of osteoporosis and increase susceptibility to heart attacks.   In addition, most will experience in varying degrees side effects such as hot flashes, insomnia, vaginal dryness, decreased sex drive, mood swings, and short-term memory loss.   For these reasons if prolonged administration is anticipated, estrogen supplementations as well as calcium supplementation are recommended.   For most women the use of the GnRH analogues would only be for a two to three month time period in preparation for some form of surgical management. 

Recently, there has been evidence that some of the desirable effects of the GnRH analogues may not be temporary.  Researchers at Georgetown University in Washington, DC found that women who have heavy bleeding from fibroids who are treated for several months still continue to have reduction in their bleeding even after discontinuation of the drug.  If this proves to be a long-term predictable effect for a significant number of women, it opens the possibility of using this treatment in a more routine fashion. 

Another affect that has been achieved with the GnRH analogue is the apparent triggering of permanent menopause in women who are very near the time of their natural menopause.  Researchers in Japan demonstrated that at least one third of treated women who were treated with these drugs who were on average age 47 would become permanently menopausal.  The advantage here is that menopause appears to be the natural "cure" for fibroids.  It causes them to stop growing and reduce in size by 50% on a permanent basis. – Francis L. Hutchins, Jr., M.D.     

RU486, more commonly known as the "Morning After Pill" or "Abortion Pill" is a drug, which has gained notoriety primarily for its ability to produce early abortion.  As the name would suggest, if you take RU486 in early pregnancy, it can cause an abortion.

One of a multitude of other potential uses that is of interest here is that RU486 has been reported to cause fibroids to shrink in size.   Initial data shows approximately 50% reductions in size of fibroid uterus; but many women have hot flashes.

This drug is still being studied in a large clinical trial at the University of Rochester.  –  Francis L. Hutchins, Jr., M.D.

2006 Update:  Rochester Study Rolls Out RU-486 To Treat Uterine Fibroids:  University of Rochester study published in the December Obstetrics and Gynecology journal.   medicalnewstoday.com Women's Health / OBGYN News,  11 Dec 2006,  Contact: Leslie Orr, University of Rochester Medical Center http://www.urmc.rochester.edu/

Asoprisnil is an experimental drug for the treatment of fibroids that causes shrinkage of the tumors and controls heavy bleeding. 

It is part of a new form of drug, which is capable of altering the receptors on the cell membrane, in this case the receptor for progesterone.  The overall effect is to decrease the progesterone effect.  Since progesterone is very important in the growth of fibroids this causes fibroids to shrink in size. 

It is anticipated that this drug may become available by the end of 2005. - Francis L. Hutchins, Jr., M.D.