Intervention Review

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Aromatase inhibitors for uterine fibroids

  1. Huan Song1,
  2. DongHao Lu1,
  3. Kate Navaratnam2,
  4. Gang Shi3,*

Editorial Group: Cochrane Gynaecology and Fertility Group

Published Online: 23 OCT 2013

Assessed as up-to-date: 23 OCT 2012

DOI: 10.1002/14651858.CD009505.pub2

How to Cite

Song H, Lu D, Navaratnam K, Shi G. Aromatase inhibitors for uterine fibroids. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD009505. DOI: 10.1002/14651858.CD009505.pub2.

Author Information

  1. 1

    Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden

  2. 2

    Institute of Translational Medicine, University of Liverpool, Department of Women's and Children's Health, Liverpool, UK

  3. 3

    West China Second University Hospital, Sichuan University, Department of Obstetrics and Gynecology, Chengdu, Sichuan, China

*Gang Shi, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20, 3rd Section of Ren Min Nan Road, Chengdu, Sichuan, 610041, China.

Publication History

  1. Publication Status: New
  2. Published Online: 23 OCT 2013



References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Parsanezhad 2010 {published data only (unpublished sought but not used)}
  • Parsanezhad ME, Azmoon M, Alborzi S,  Rajaeefard A,  Zarei A, Kazerooni T,  et al. A randomized, controlled clinical trial comparing the effects of aromatase inhibitor (letrozole) and gonadotropin-releasing hormone agonist (triptorelin) on uterine leiomyoma volume and hormonal status. Fertility and Sterility January 2010;93(1):192-8.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Badawy 2012 {published data only}
  • Badawy AM, Elnashar AM, Mosbah AA. Aromatase inhibitors or gonadotropin-releasing hormone agonists for the management of uterine adenomyosis: a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica 2012;91(4):489-95.
Nassar 2009 {unpublished data only}
  • Nassar A. Aromatase inhibitors for treatment of uterine leiomyomas. 2009. [: NCT00945360]

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Bedaiwy 2009
  • Bedaiwy MA, Mousa NA, Casper RF. Aromatase inhibitors prevent the estrogen rise associated with the flare effect of gonadotropins in patients treated with GnRH agonists. Fertility and Sterility 2009;91 Suppl(4):1574-7.
Biri 2008
  • Biri A, Korucuoglu U, Zumrutbas N, Tiras B, Guner H. Intravenous leiomyomatosis treated with aromatase inhibitor therapy. International Journal of Gynaecology and Obstetrics 2008;101(3):299-300. [PUBMED: 18280477]
Bulun 1994
  • Bulun SE, Simpson ER, Word RA. Expression of the CYP19 gene and its product aromatase cytochrome P450 in human uterine leiomyoma tissues and cells in culture. The Journal of Clinical Endocrinology and Metabolism 1994;78(3):736-43.
Bulun 2005
  • Bulun SE, Imir G, Utsunomiya H, Thung S, Gurates B, Tamura M, et al. Aromatase in endometriosis and uterine leiomyomata. The Journal of Steroid Biochemistry and Molecular Biology 2005;95(1-5):57-62. [PUBMED: 16024248]
Buzdar 2002
Cole 1990
  • Cole PA, Robinson CR. Conversion of 19-oxo[2 beta-2H]androgens into oestrogens by human placental aromatase. An unexpected stereochemical outcome. The Biochemical Journal 1990;268(3):553-61.
Cramer 1990
Day 2003
  • Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. American Journal of Obstetrics and Gynecology 2003;188(1):100-7.
Donnez 2002
  • Donnez J, Jadoul P. What are the implications of myomas on fertility? A need for a debate?. Human Reproduction 2002;17(6):101-7.
Egger 1997
FDA 2010
  • FDA. FDA Alert: Aromatase inhibitors in products marketed as dietary supplements: recall. (accessed 25 December 2010).
Felson 2005
Firouznia 2009
  • Firouznia K,  Ghanaati H,  Sanaati M,  Jalali AH,  Shakiba M. Pregnancy after uterine artery embolization for symptomatic fibroids: a series of 15 pregnancies. AJR American Journal of Roentgenology 2009;192(6):1588-92.
Franik 2012
  • Franik S, Kremer JAM, Nelen WLDM, Farquhar C. Aromatase inhibitors for subfertile women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews 2012, (12).
Gershanovich 1998
  • Gershanovich M, Chaudri HA, Campos D, Lurie H, Bonaventura A, Jeffrey M, et al. Letrozole, a new oral aromatase inhibitor: randomised trial comparing 2.5 mg daily, 0.5 mg daily and aminoglutethimide in postmenopausal women with advanced breast cancer. Letrozole International Trial Group (AR/BC3). Annals of Oncology 1998;9(6):639-45.
Goss 2001
  • Goss PE, Strasser K. Aromatase inhibitors in the treatment and prevention of breast cancer. Journal of Clinical Oncology 2001;19(3):881-94.
Gupta 2012
Gurates 2008
Han 2008
  • Han M, Kim JY, Park JE, Kim JM, Lee KS. Effects of letrozole on proliferation and apoptosis in cultured leiomyoma cells treated with prostaglandin E(2). European Journal of Obstetrics, Gynecology, and Reproductive Biology 2008;138(1):83-8.
Higgins 2011
  • Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011.
Hilário 2009
Hindley 2004
  • Hindley J, Gedroyc WM, Regan L, Stewart E, Tempany C, Hynyen K, et al. MRI guidance of focused ultrasound therapy of uterine fibroids: early results. AJR. American Journal of Roentgenology 2004;183(6):1713-9.
Howell 2005
  • Howell A, Cuzick J, Baum M, Buzdar A, Dowsett M, Forbes JF, et al. ATAC Trialists' Group. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years' adjuvant treatment for breast cancer. Lancet 2005;365(9453):60-2.
Ishikawa 2009
  • Ishikawa H, Reierstad S, Demura M, Rademaker AW, Kasai T, Inoue M, et al. High aromatase expression in uterine leiomyoma tissues of African-American women. The Journal of Clinical Endocrinology and Metabolism 2009;94(5):1752-6.
Kaunitz 2007
Ke 2009
Lepine 1997
  • Lepine LA, Hillis SD, Marchbanks PA, Koonin LM, Morrow B, Kieke BA, et al. Hysterectomy surveillance-United States, 1980-1993. MMWR. CDC Surveillance Summaries 1997;46(4):1-15.
Misso 2012
Moss 2011
Nasu 2009
  • Nasu K, Tsuno A, Takai N, Narahara H. A case of benign metastasizing leiomyoma treated by surgical castration followed by an aromatase inhibitor, anastrozole. Archives of Gynecology and Obstetrics 2009;279(2):255-7.
Pavone 2012
Pavone 2013
  • Pavone ME, Bulun SE. Clinical review: the use of aromatase inhibitors for ovulation induction and superovulation. Journal of Clinical Endocrinology and Metab 2013;98(5):1838-44.
Pron 2003
  • Pron G, Bennett J, Common A, Wall J, Asch M, Sniderman K, Ontario Uterine Fibroid Embolization Collaboration Group. The Ontario Uterine Fibroid Embolization Trial. Part 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids. Fertility and Sterility 2003;79(1):120-7.
Rivera 2004
  • Rivera JA, Christopoulos S, Small D, Trifiro M. Hormonal manipulation of benign metastasizing leiomyomas: report of two cases and review of the literature. The Journal of Clinical Endocrinology and Metabolism 2004;89(7):3183-8. [PUBMED: 15240591]
Shozu 2002
  • Shozu M, Sumitani H, Segawa T, Yang HJ, Murakami K, Kasai T, Inoue M. Overexpression of aromatase P450 in leiomyoma tissue is driven primarily through promoter I.4 of the aromatase P450 gene (CYP19). Journal of Clinical Endocrinology and Metabolism 2002;87(6):2540-8.
Simpson 2003
Singh 2007
  • Singh SS,  Bordman R,  Leyland N. Pregnancy after uterine artery embolization for fibroids. Canadian Family Physician 2007;53(2):293-5.
Stewart 2001
Sumitani 2000
  • Sumitani H, Shozu M, Segawa T, Murakami K, Yang HJ, Shimada K, et al. In situ estrogen synthesized by aromatase P450 in uterine leiomyoma cells promotes cell growth probably via an autocrine/intracrine mechanism. Endocrinology 2000;141(10):3852-61.
Varelas 2007
Walker 2005
Wallach 2004
Wu 2007
Yoon 2013
  • Yoon SW, Cha SH, Ji YG, Kim HC, Lee MH, Cho JH. Magnetic resonance imaging-guided focused ultrasound surgery for symptomatic uterine fibroids: estimation of treatment efficacy using thermal dose calculations. European Journal of Obstetric and Gynecological Reproductive Biology 2013 Mar 21.