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Miracle Drug for Fibroids

One of the new treatments for fibroids stands out as being the miracle moonclosest thing to a “miracle drug”  for fibroids as we’ve found yet. So, given that up to 70% of women will experience fibroids in their lifetime, what is this drug and why haven’t you heard of it?

Mifepristone is a progesterone receptor antagonist: it blocks progesterone receptors in fibroids, thereby interrupting hormonal stimulation or perpetuation of fibroids, and results in shrinkage of fibroids.

Several randomized, placebo-controlled studies (the gold standard) have shown that mifepristone given in 5 to 10 mg dosages daily for three months can reduce fibroid size by 25-75%!

miracle lights Women taking mifepristone experience a drastic reduction in symptoms, including complete cessation of bleeding and decreased pelvic pressure.

Mifepristone is inexpensive to produce and has few side effects:

  • uterine hyperplasia (temporary overgrowth of the uterine lining), 14-28%
  • elevated liver functions (reversible, no evidence of long-term adverse effects on the liver), 4%

So, given that women experience the most trouble from fibroids in the mid to late-forties, and fibroids will shrink after menopause, why isn’t mifepristone, a cheap, highly effective drug with few side effects, widely available for conservative management of fibroids during the pre-menopausal years when women are most symptomatic????

Politics and Medicine: Women are the Playing Field

road closed

Well: Mifepristone is also known as RU-486 or “the abortion pill”. In  higher doses (200 mg) administered before 49 days of pregnancy, mifepristone interferes with implantation of an embryo and can induce abortion.

So, good luck trying to get it approved in the United States anytime soon. Right now the drug is synthesized primarily in France, and the company making the drug has safeguards in place to protect it from violence and litigation from anti-abortion activists. Most research done on applications for the use of mifepristone to treat medical conditions is conducted in Europe and South America.

Questions:

  • If you had fibroids and could stop the symptoms with mifepristone long enough to get you through to menopause, would you take the drug?
  • If a cheap drug with few side effects was available to men to reduce prostate enlargement, how fast do you think that drug would fly through the US FDA approval process, even if it could be used to induce abortions?

Mifepristone is a sad example of how political concerns can disrupt science and prevent good treatments from getting to market.

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{ 13 comments… add one }

  • Patient S April 10, 2009, 4:21 pm

    Hi Dr Binkley and Lisa,
    I am interested in the mifepritone, it sounds pretty perfect. I am thinking also of doing the hydrothermablation in addition. Do you have an idea how long it will talk for you to receive the Mifepristone and how much it will cost? I also can’t remember the cost for hydrothermablation?
    Thanks, Patient

    • Shelley Binkley April 17, 2009, 9:34 am

      Hi! Thank you for your interest in the mifepristone. We are also beginning to use Arimidex (anastrazole, a breast cancer drug) to treat fibroids in some patients. Small studies have shown it may be as effective as mifepristone, and certainly less controversial. Let us know if you are interested in this. 970-945-4499. I changed the name on this response for patient privacy issues.
      We are also using the combined approach of fibroid-shrinking medications with the hydrothermablation to give people longer-lasting results from both for treatment of fibroids.
      Regarding the costs of these options, our financial expert can assist you with information on the costs of various options, what insurance covers, what it doesn’t, etc. You can contact the office and ask for “Billing” and you will be directed to the best medical billing specialist I know. ;-)
      –Thank you for your reply. –Shelley

  • Maxine McKenzie August 3, 2009, 8:01 am

    Could you please let me know if there is any treatment available in or outside the United Kingdom for using mifepristone to treat fibroids? I have large fibroids and already had a multiple myomectomy 5 years ago, but they’ve definitely grown. I would also be interested in the possibility of being a participant on a mifepristone research programme for fibroids – would you know of any? I only heard about this drug through your website and would be most interest myself in raising awareness about its use for fibroids. I think it’s a shame that there is very little info on its use for fibroids.

    Thank you for your help and look forward to hearing from you.

    Maxine

    (please note – I have also expressed my interest in aromatase inhibitors in the comment box left for that).

    • Shelley Binkley September 16, 2009, 9:24 am

      Mifepristone is an option but it is hard to obtain due to the abortion problem. A better option is Arimidex which is easily available for off-label use to treat both endometriosis and fibroids. Arimidex is FDA approved to treat breast cancer and it is not used as an abortifacient so it sidesteps the whole problem with mifepristone. The dose is 1 mg daily X 90 days to shrink fibroid volume by 50%. It can be repeated at intervals if symptoms recur after a few years of the first use. Arimidex and other aromatase inhibitors are sometimes used in high risk patients to decrease risk for breast cancer. Did you see the articles on aromatase inhibitors on this site?

  • Elaine Fitzpatrick October 3, 2009, 8:20 am

    Are there any side effects or risks associated w/ 1mg of Arimidex x 90 days? This sounds like a better option than GnRH agonists. Does it induce menopause or cause hot flashes? How would I go about finding a Dr. in Atlanta willing to prescribe it off-label? I have a family history of ovarian cancer (mom died at 78)–would this make me a poor candidate for this? Many thanks-Elaine

    • Shelley Binkley October 5, 2009, 9:21 am

      The side effects of Arimidex and other aromatase inhibitors are menopausal symptoms–hot flashes. However, the benefits of these meds for reducing fibroid size and volume with a 90-day treatment, compared to the risks of hysterectomy, make aromatase inhibitors a good choice for women who want a non-surgical option for treatment of fibroids. As far as finding someone who will prescribe them, talk to your local primary care doc or gyn about it.

  • Christina January 6, 2011, 12:00 pm

    Hello Dr. Binkley,

    I just came across this site because I’m looking for alternative ways of shrinking fibroids. Several years ago I had a robotic myomectomy that was supposed to be minimally-invasive, but that took me several weeks to recover from. This past October I had another minimally-invasive procedure (MRI-guided ultrasound ablation) that was semi-successful in alleviating the bulk symptoms but that didn’t shrink the fibroid. I’d like to find something that shrinks it, though, b/c I look about 4 months pregnant (At the time of the procedure the fibroid was 12.5 cm). It’s less significant in size, but still quite bothersome. I’ve heard that the drug EllaOne from France is now approved, and as of last summer there was work on having it approved for fibroids. Do you know anything about this? If it has been approved, what would your choice be between this and Arimidex? If someone takes 1 pill of Ella for pregnancy prevention, I’m concerned what effect taking 90 pills in 90 days would have on my system. Thank you for your comments.

  • Tracey Johnson January 27, 2011, 2:56 pm

    Is either of the treatments you referred to just as effective for breast fibroids? I have a large fibroid in my right breast and instead of traditional surgery which would basically disfigure me, I would prefer to shrink it down to a size where cryoablation surgery would be an option for me. To be considered for the cryoablation surgery, which is minimally invasive, the tumor cannot exceed 4cm. Mine is ranging around 7 cm. I need to shrink it to at least half the size.

    • Shelley Binkley April 4, 2011, 1:41 pm

      There’s not a lot of data on using anastrazole for fibroicystic breast changes.

  • Anne Breen September 26, 2011, 3:40 am

    I had large uterine fibroids and a meningioma brain tumor which look identical under a medical microscope. I take mifepristone with FDA approval and it has successfully blocked the regrowth of my recurent meningioma. If I could have taken this safe alternative medication in the USA after my first brain tumor I might never have needed a second craniotomy or a total hysterectomy. Modern medical care is supposed to be based on advances in medical science, not US politics, religious beliefs and/or hospital profits. My medical care would have been much safer, cheaper and easier, if I could have avoided these additional major surgeries and hospitalizations.

    • Shelley Binkley December 16, 2013, 7:30 am

      Interesting!

  • jennifer July 17, 2012, 1:05 am

    HI, I have tried for 3 months the ELLA drug.My fibroid s did not shrink but they did not grow.I did though stop bleeding for 5 months so I was able to finally not be anemic!! The drug had to be compounded and with my insurance was still $300 a month:( I would like info on the other one I see you all were talking about.Are the side effects the same as the ELLA ? Thanks for any input.I am 44 so I am trying to make it until menopause.

    • Shelley Binkley December 15, 2013, 6:54 am

      Hi Jennifer,

      ELLA is an emergency contraceptive. It’s not typically used to treat endometriosis, but it could be used for that purpose. I recommend you speak with your Ob Gyn about your options.

      Thank you for reading the blog and commenting.

      -Dr. B

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