Effect of letrozole on shrinking the size of uterine fibroids in symptomatic patients of the reproductive age group

Abstract

Objective: To compare the mean fibroid size (cm) before and after treatment with letrozole and the frequency of symptom improvement in symptomatic patients of the reproductive age group.

Methodology: Quasi-experimental study was conducted between November 1^st, 2024, and April 30^th, 2025, at the Obstetrics and Gynaecology Department of Nishtar Hospital in Multan. Thirty women aged 25-45 who presented to the outpatient department were enrolled in this study. Throughout the trial, married women were encouraged to use barrier methods of contraception. Symptoms were graded according to the operational definition. Every woman took 5mg of the tablet Letrozole daily for three months. The myoma size before and after treatment, and the improvement of symptoms, were recorded.

Results: The mean age of the study population was 34.70 ± 5.31 years. Most patients were married (76.7%, n=23), had 0–2 children (66.7%, n=20), and were non-obese (73.3%, n=22). Leiomyomas were primarily single in 63.3% (n=19) patients, with a mean size of 4.63 ± 1.22 cm, and 60.0% (n=18) exceeded 5 cm. Letrozole therapy significantly reduced uterine fibroid size from 5.37 ± 0.88 cm (pre-treatment) to 4.64 ± 0.70 cm (post-treatment), with a mean reduction of 0.73 cm (p=0.003). Among 30 patients, 66.7% (n=20) reported symptom improvement after letrozole therapy.

Conclusion: Reduced uterus-leiomyoma size, improved control of related symptoms, and fewer adverse effects were observed after treatment with Letrozole.

Key Words: Aromatase Inhibitors; Fibroid; Leiomyoma; Letrozole; Uterine fibroids;