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Federación Mexicana de Ginecología y Obstetricia, A.C.

2008, Número 10

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Ginecol Obstet Mex 2008; 76 (10)


Relación de la terapia hormonal, la tibolona y los SERMs con el crecimiento de miomas en la mujer posmenopáusica

Carranza LS

Idioma: Español
Referencias bibliográficas: 34
Paginas: 610-614
Archivo PDF: 179.56 Kb.


RESUMEN

Los miomas (leiomiomas o fibromas) son los tumores uterinos benignos más frecuentes en la mujer, pues se encuentran en 77% de los especímenes de histerectomía. Está reportado que la terapia hormonal (estrógeno-progestina) previa, por más de cinco años, se asocia con riesgo elevado (cuatro veces más alto) de producir leiomiomas. Un estudio en pacientes sin miomas demostró la producción de estos tumores (5%) después de recibir la combinación transdérmica-oral durante 24 meses, mientras que nos los hubo en aquellas que sólo recibieron tratamiento oral. La terapia homonal aumenta el volumen del o los miomas, o tiene un efecto neutro. La terapia transdérmica parece tener un efecto mayor en el crecimiento del mioma. La tibolona tiene un efecto neutro en el volumen del mioma y el raloxifeno en la dosis habitual no estimula su crecimiento. Si las mujeres posmenopáusicas con miomas necesitan tratamiento para el control de los síntomas, la terapia hormonal no es la mejor opción; sin embargo, la tibolona puede ser más adecuada y el raloxifeno prescribirse en aquellas pacientes asintomáticas.


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