August 9th, 2022

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Endometrial Effects of Prolonged Therapy with the Selective Progesterone Receptor Modulator Ulipristal Acetate: A Case Report
Authors:  Gary Levy, M.D., John Elkas, M.D., Alicia Y. Armstrong, M.D., and Lynnette K. Nieman, M.D.
BACKGROUND: Prolonged exposure to a selective progesterone receptor modulator (ulipristal acetate) in a patient with benign metastasizing leiomyoma did not result in endometrial hyperplasia or neoplasia.

CASE: A woman with history of benign metastasizing leiomyoma underwent medical treatment for 5 years with ulipristal acetate. Endometrial biopsies were performed at established intervals to monitor for intraepithelial neoplasia or progesterone receptor modulator–associated endometrial changes (PAECs). The patient tolerated UPA therapy well; there was no evidence of hyperplasia or proliferative changes associated with progesterone-associated endometrial changes.

CONCLUSION: In this case prolonged exposure to ulipristal acetate did not result in premalignant or malignant endometrial pathology.
Keywords:  contraceptive agents; Ella norpregnadiene; endometrial hyperplasia; Esmya; fibroid; fibroids, uterine; leiomyoma; progesterone receptor; selective progesterone receptor modulator; ulipristal acetate
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