Mifepristone's Efficacy for Symptomatic Relief and Size Reduction in Uterine Fibroids: A 2023 Prospective Observational Study at Rabia Balkhi Hospital, Afghanistan.

Background Uterine fibroids (leiomyomas) are common benign tumors, affecting 70-80% of women by age 50, and can cause symptoms such as heavy bleeding, pelvic pain, and pressure, significantly impacting the quality of life. In severe cases, fibroids may lead to infertility or miscarriage, making their management a key healthcare challenge. Traditional treatments, including hysterectomy, may not be suitable for women wishing to preserve fertility or avoid surgery. Mifepristone, an antiprogestogen, has shown promise as a non-invasive alternative by blocking progesterone, which promotes fibroid growth. It has been proven to reduce fibroid size and alleviate symptoms, offering a valuable option for women seeking alternatives to invasive procedures. Objective This study aimed to evaluate the efficacy of mifepristone in providing symptomatic relief and reducing fibroid size in patients with uterine fibroids at Rabia Balkhi Hospital, Kabul, Afghanistan, in 2023. Methodology A descriptive, prospective study was conducted from January to June 2023, enrolling 20 women with symptomatic uterine fibroids. The inclusion criteria were women aged 30-55 years with clinically diagnosed fibroids causing symptoms such as heavy bleeding or pelvic pain. Exclusion criteria included pregnancy, active infections, or other uterine pathologies. Patients were treated with 25 mg of mifepristone daily for three months. Follow-up assessments were conducted at one, two, and three months to monitor clinical outcomes, including changes in bleeding, fibroid size (measured by ultrasound), and hemoglobin levels. Results Twenty patients (6.25%) with symptomatic fibroids were treated with mifepristone. The majority of cases were in patients aged 46-55 years (50%). Treatment led to a reduction in bleeding in 78% of patients, a decrease in fibroid size in 42.6%, and a reduction in menorrhagia in 44%, evidenced by fewer daily sanitary products used. Hemoglobin levels improved in 33.5% of patients, with an average post-treatment level of 11.8 ± 1.4 g/dL. Statistical significance was set at p < 0.05, supporting mifepristone's efficacy in managing symptomatic fibroids and enhancing patient quality of life. Conclusion Our study concludes that mifepristone at 25 mg is an effective and accessible treatment for fibroids, the same as other published evidence. It offers a practical and economical alternative to surgery, reducing bleeding, inhibiting fibroid growth, and decreasing fibroid size. These findings have significant public health implications, reassuring patients and healthcare providers about the accessibility of effective fibroid treatment.