One of the new treatments for fibroids stands out as being the closest 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%!
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
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.
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.