The Effect of Progestins on the Mitotic Activity of Uterine Fibromyomas

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Abstract
Previous studies have shown increased mitotic activity in uterine fibromyomas in patients using exogenous hormones. This study has compared the mitotic activity of fibromyomas in 3 groups of patients. The 1st group was using a progestin-only preparation (usually depo-medroxyprogesterone acetate). The 2nd group of age-matched controls had never used any exogenous hormone. The 3rd group of patients was using a combined estrogen/progestin oral contraceptive. The results show that patients using a progestin-only preparation have a significantly higher mitotic activity in fibromyomas than patients from the other 2 groups: results from patients using a combined estrogen/progestin preparation were the same as the controls. The highest count was 39 mitoses/100 higher power fields (HPF), but focal areas containing up to 8 mitoses/10 HPF could be found. In none of the fibromyomas examined did the count exceed 10 mitoses/10 HPF, and none showed significant pleomorphism that might have been confused with malignancy.