| Background and aim: Despite the high prevalence of uterine leiomyoma, according to recent
review studies there is uncertainty and a paucity of information regarding its predisposing or
protective factors. The aim of this study was to assess the possible association between menstrual
cycle pattern and occurrence of surgically treated myomas and also to check if depomedroxyprogesterone
acetate (DMPA) injection earlier in reproductive life can affect the later
occurrence of myomas needing surgical treatment.
Methods: In a case–control study in Ardabil, 85 women with definite diagnosis of surgically
treated uterine leiomyoma and 154 community controls were enrolled. Possible predictors of
myoma including menstrual cycle and menstrual bleeding patterns were assessed. Data were
analyzed using SPSS software (SPSS, IBM, Somers, NY). Odds ratios were used as the main
statistic in assessing the strength of observed associations.
Results: Mean age of the participants was 41.8 ± 8.5 years. Length of menstrual cycle was
associated with myoma and a higher likelihood of myoma was observed among those having
shorter menstrual cycles (P , 0.05). Number of menstrual bleeding days was also associated
with surgically treated myoma and longer bleeding periods increased the likelihood of myoma
(P , 0.05). Only one of the eight women who had a history of depo-medroxyprogesterone
acetate injections had developed surgically treated uterine leiomyoma and the others belonged
to the control group without a history of surgical treatment for uterine leiomyoma.
Conclusion: Menstrual cycle pattern is associated with developing leiomyomas requiring surgical
treatment. DMPA, other than its role in myoma treatment, is also assumed to have a role
in preventing myomas, but due to the small sample size in this study, larger scale prospective
trials are needed in the future. |