Esmya for fibroids: instructions for use, reviews, price

Representatives of the fair sex, in our time, are very often exposed to “female” problems that can negatively affect their reproductive function. That is why medicine does not stand still and within a short amount of time the latest, highly effective drugs are produced that prevent the development of unfavorable diseases. One of the most common pathologies is considered to be a malignant or benign formation, localized in the uterine cavity and bringing a woman a lot of discomfort.

The drug Esmya for uterine fibroids or other equally common female diseases is very popular among its analogues and, based on the results of medical research, consists of active and safe active substances.

Relationship between fibroids and gestagens

For a long time, gestagen preparations in various dosages were used to treat fibroids. Most often, therapy was carried out with Duphaston. But later studies showed that with such treatment the size of the nodes does not decrease, and sometimes, on the contrary, increases. Similar processes were observed during pregnancy and in the luteal phase of the cycle. Due to the natural increase in progesterone, the growth of nodes accelerated.

Studies have shown that in myomatous tumors the number of progesterone receptors is increased by 70% compared to healthy tissues. This hormone stimulates cell division and blocks apoptosis. Estrogen is to blame for the increase in the number of receptors, which stimulates the formation of new progesterone receptors.

To reduce the size of lesions, medications are used that suppress the functioning of the ovaries and the production of estrogen. But their side effects affect the genitals and the musculoskeletal system. Women experience temporary menopause due to this treatment. After discontinuation of the drug, the symptoms of the disease return. This treatment is not suitable for everyone.

Research has made it possible to create drugs that affect the process of apoptosis and division of leiomyoma cells and cause less harm to the body.

Patient reviews

The use of “Esmiya” for fibroids has many reviews, which, depending on the individuality of the female body, can differ significantly from each other. You should not draw conclusions based on other people’s opinions and self-medicate. The main factor that guarantees a positive result is a serious approach to therapeutic measures and strict adherence to all recommendations of a qualified healthcare professional.

Tamara, 35 years old:

I had an annual examination with a gynecologist 6 months ago and, at the time of the procedure, the doctor stated that I had been diagnosed with a benign tumor neoplasm with a diameter of 10 weeks and sent me for a detailed hardware examination and the necessary tests. Based on the results of the study, the doctor warned that if you do not immediately begin conservative therapy, then surgical intervention cannot be avoided and prescribed the drug “Esmiya”. The full course of treatment lasted for three months. While using this drug, I fortunately did not experience any serious side effects other than minor mood swings and occasional insomnia. After I took the required amount of pills, I went for a re-examination, which showed that the myomatous node had become significantly smaller and was now 5 weeks old. Now I am undergoing a repeated therapeutic course and hope that the tumor will completely disappear. Based on my own positive results, I can confidently recommend this product, which, despite the high price, fully corresponds to it.

Diana, 38 years old:

About 5 years ago, during an industrial medical examination, the gynecologist discovered a small fibroid in my uterine cavity and did not prescribe any treatment, based on the fact that the tumor was too small (1.5 cm). After two years, I decided to undergo the examination again, the result of which, to put it mildly, did not please me at all. The myomatous node increased 5 times and now its diameter was 7.5 cm. The doctor, as a therapeutic measure, advised surgical removal of the tumor, which scared me very much, and I decided to further consult with other specialists. That’s how I came across the hormonal drug Esmiya. I used it throughout the winter and experienced a lot of side effects: frequent dizziness, excessive sleepiness, back pain and weight gain. Such symptoms, to put it mildly, did not make me happy, but my opinion changed in the spring during a re-examination. The size of the benign formation has become two times smaller. The therapeutic course can be repeated only after 2 months, but I am already looking forward to this moment, because I hope that with the help of this medication I will be able to get rid of the disease completely. I believe that Esmiya is a good drug, but you should be prepared for unfavorable side effects.

Constance, 46 years old:

A preventive examination, which was carried out a year ago, showed that a benign tumor had formed in the cavity of my uterus - a fibroid. This statement, as expected, shocked me. My attending physician explained that if after some period of time, during a routine examination, an enlargement of the tumor node is detected, then immediate surgical intervention will be necessary to remove it. A repeat ultrasound scan was scheduled for me after 4 months and, at the time of its examination, they discovered the active growth of the tumor. Fortunately, as I thought at that time, the gynecologist offered me an alternative treatment - the use of the hormonal drug Esmiya. For three months I took this pharmacological drug and was subject to negative “side effects”: periodic headaches and dizziness, nausea, vomiting and frequent cases of intestinal obstruction. After the course of therapy was completed, I immediately ran for a gynecological examination to hear about the positive results, but, unfortunately, there were none. After a second examination, the doctor stated that the only effect that the medication brought was stopping the growth of the fibroid node. This statement shocked me, I endured the appearance of a bunch of negative symptoms, and all this turned out to be in vain. Later I had surgery to remove the tumor. I categorically do not recommend using this medication when fighting uterine fibroids.

Features of the drug

The active ingredient is ulipristal, which modulates receptors for the hormone progesterone in the tissues of the uterus. It acts selectively, so there is no complete antigestagenic effect.

To the question whether Esmya is a hormonal drug or not, the instructions do not give a clear answer. According to the pharmacological group, it belongs to estrogens, gestagens, their homologues and analogues. This is a substance that does not have the effect of hormones, but affects their action in the body.

Esmya is available in the form of 5 mg tablets. One package can contain 28 or 84 tablets. The latter option is designed for one full course of therapy. But the price of a large package is high, so some women prefer to buy them monthly.

The composition includes additional substances that help maintain shape and are necessary for absorption:

microcrystalline cellulose;
mannitol;
talc;
sodium stearate

They are inert and do not affect the metabolism of the main substance.

The action of Esmya is limited only to fibroid myocytes. The substance does not affect healthy uterine cells, which also contain progesterone receptors. This is how the selective antiprogestagenic effect is realized.

Effect of Esmya on the reproductive organs and pituitary gland

One of the points of application of Esmya is the endometrium. Start taking the drug from the first days of the menstrual cycle. Under the influence of ulipristal, bleeding stops even in women with fibroids. The next menstruation does not begin when taking Esmya. This effect is associated with blocking progesterone receptors. The endometrium changes its morphological structure. In some cases it becomes thinner. The reason is the lack of the stimulating effect of progesterone in the first phase of the cycle, when normally there is an active increase in thickness.

In 60% of women, the endometrium does not decrease when taking Esmya, but remains of normal thickness or even increases. Often such changes are mistaken for hyperplasia. But studies have shown that there are no atypically changed cells in the tissue, and the increase in volume occurs due to cystic expansion of the endometrial glands. No special treatment or drug withdrawal is required in this condition. The uterine epithelium becomes of normal thickness within 3 months after cessation of treatment. Otherwise, an examination and search for another cause of deviations is necessary.

Blocking progesterone receptors in leiomyoma leads to inhibition of proliferation - cell division. Therefore, the tumor loses its ability to grow in size. Stimulation of apoptosis, or programmed cell death, leads to gradual regression of the nodes. The degree of reduction varies from person to person. A maximum size reduction of 67% has been reported in several clinical trials. The results after discontinuation of Esmya last for several months.

The effect of the drug also extends to the pituitary gland. Under its influence, there is a decrease in the release of follicle-stimulating hormone. In women undergoing treatment, ovulation is suppressed. But the drug does not affect the concentration of estradiol, so there are no unwanted reactions associated with a lack of estrogen. Esmya does not affect the production of prolactin, adrenocorticotropic hormone and thyroxine-binding globulin (involved in the functioning of the thyroid gland).

Properties and advantages over other medications

The hormonal drug Esmya has antihistogenic properties, due to the content of the patented substance uliprestal acetate, it directly acts on the nodes of fibroids, stops the growth of its tissues and causes the death of tumor cells. As a result, under the influence of the therapeutic agent, the tumor begins to shrink, which is also important during the period of preparation for surgical removal of fibroids, as it allows you to reduce the volume of tissue removed.

When treating fibroids, the use of Esmiya normalizes blood loss during menstruation and prevents the development of anemia. Compared to previous drugs used to treat myomatous formations, the new drug has a number of advantages:

Reduces the activity of progesterone receptors, resulting in a decrease in the amount of hormones and a halt in tumor development.
By acting on the pituitary gland, it acts as a contraceptive.
Does not cause a decrease in estrogen levels, does not reduce bone density.
It affects only damaged myometrial cells.
Has an antimicrobial effect, suppressing the development of infections.
Stops uterine bleeding of any intensity, eliminates pain symptoms, and prevents the development of anemia.
Restores fertility to women.
It has a cumulative effect, the therapeutic effect lasts for at least six months after stopping the drug.
It is well tolerated by patients and has virtually no side effects.

In what conditions is it prescribed?

Initially, Esmya was used in patients in terms of preoperative preparation, which made it possible to reduce the size of nodes in 1 course of treatment. The positive effects of such training are:

Treatment of anemia - after stopping heavy menstrual bleeding, taking iron supplements becomes more effective and helps restore hemoglobin concentration. In the absence of anemia, the operation is easier to tolerate, and standard blood loss does not pose a great danger.
The operation is easier - a small node is easier to remove, and the incision on the uterus will be smaller. A neat small scar will form on the organ, which will not become a serious obstacle to pregnancy.
The uterus can be removed through the vagina - if a woman was planning an extirpation, the uterus with reduced tumors can be removed through a vaginal approach without cutting the anterior abdominal wall. The recovery period after such an operation is shorter, there is no significant pain, and there is less risk of complications and subsequent formation of adhesions.

For submucosal fibroids, the use of Esmya is allowed, in contrast to the prohibited embolization of the uterine arteries. Ulipristal does not affect blood flow, and there is no risk of necrosis or torsion of the node. The node, which decreases under the influence of therapy, will no longer deform the uterine cavity. It is later removed through vaginal access.

Esmiya is not used in girls under 18 years of age. Myoma is a disease of reproductive age, so girls have no pathology before menstruation. The drug is not used in adolescents due to the lack of information about its safety; clinical trials are not conducted in this age group.

Currently, Esmya is used as a means of conservative treatment of fibroids in women in the following cases:

there is a desire to preserve the uterus and give birth to a child;
there is no consent for the operation;
There are risks of performing surgery or using anesthesia.

According to research, a course of 3 months is safe for the treatment of fibroids. After the end of treatment, there is no significant increase in the size of the node within a month, in contrast to drugs from the group of GH antagonists. A repeated course after a few months allows you to achieve an even greater reduction in the size of the nodes. It is acceptable to carry out 2 courses of therapy.

Is it possible to treat fibroids with Esmya during menopause?

For women of this age, there is no need to maintain reproductive function. Therefore, the drug can only be used for a short course during preoperative preparation.

Indications for the use of ulipristal are fibroids of moderate to moderate severity. With large nodes, the effectiveness of drug therapy is sharply reduced.

In patients with endometriosis, a positive effect on its course was observed. Research is currently underway on the possibility of its use not only for fibroids. Endometriotic lesions are also sensitive to progesterone concentrations. A decrease in its concentration leads to a decrease in tissue proliferation in pathological foci. When Esmya's research is completed, it is possible that a safe drug will appear that will allow women with endometriosis to have children.

Metabolism of the drug

Tablets at a dosage of 5 mg (sometimes 10 mg are prescribed) are quickly absorbed after oral administration. Reaches maximum concentration in the blood within an hour. But taking a fatty meal during breakfast slows down the absorption of the drug. Studies show that this does not significantly affect the therapeutic effect, but doctors do not recommend drinking Esmya after a fatty meal.

After penetration into the blood, ulipristal binds to plasma proteins. Metabolism takes place in the liver with the participation of enzymes of the cytochrome P450 system. In women with liver failure or impaired liver function, caution should be exercised when prescribing this therapy.

After the launch of mass production of ulipristal, more than 760 thousand women were treated. But recently, 8 cases of severe liver damage have been reported. Therefore, in February 2021, a temporary ban on the use of the drug was published by the European Medicines Agency. More research has been conducted on the effects of Esmya on the liver. The committee published the results of the examination, which established a possible cause-and-effect relationship between the drug and toxic hepatitis. The use of Esmya continues, but taking into account the recommendations of the European Medicines Agency.

Metabolites are excreted through the intestines, 10% by the kidneys. It does not have a significant effect on the metabolism of other drugs. It is impossible to talk about Esmiya’s compatibility with alcohol. Enzymes of the cytochrome system are also involved in the metabolism of ethanol. Therefore, simultaneous use will be more likely to cause liver toxicity.

Rules for effective use

Instructions for use for uterine fibroids recommend taking 1 tablet per day at the same time (preferably in the morning). The first tablet is taken before the 4th day of menstruation.

The time for taking Esmya should not be missed. If you forget to drink it, you need to do it as soon as you remember. If the interval from the time of administration is more than 12 hours, you do not need to take an additional tablet. It is enough to resume the previous treatment regimen the next morning.

The duration of the course of therapy is 3 months. In women who are not scheduled for surgery, repeat treatment may be performed. To do this, wait until the menstrual cycle returns. Normally, menstruation begins 4 weeks after stopping treatment with Esmya. To start a new course, 2 normal menstruation must have passed.

The European Medicines Agency gives its recommendations on how to take Esmya correctly, taking into account the risk of liver damage:

The drug is not prescribed to women with moderate and severe liver failure.
Before taking Esmya, evaluate liver function using liver enzyme tests. If there is an excess of the norm by 2 times or more, treatment is not started.
During the course of therapy, tests are taken once a month to monitor liver function. They are repeated 2-4 weeks after the end of treatment. If during treatment the enzymes increase 3 times compared to the norm, the drug is discontinued.
To prepare for surgery, only 1 course is prescribed; for those who are not planning surgical treatment, a repeat course can be taken.
If yellowing of the skin, sclera of the eyes, fatigue and bitterness in the mouth appears, you should immediately consult a doctor.

Women with renal failure do not need to adjust the dose of Esmya or take additional medications. Contraindications include severe renal impairment and inability to control the condition.

Negative consequences of treatment

The manufacturer indicates possible side effects, many of which were identified during clinical trials.

Amenorrhea while taking the drug is a side effect, but it is also the goal of therapy. There is no need to cancel treatment; the absence of menstruation indicates the effectiveness of the process.

93% of women experience hot flashes. They are not as pronounced as when treated with antiestrogenic drugs that cause artificial menopause. The condition disappears on its own and does not require additional treatment.

On the part of neuropsychic activity, a state of anxiety or depression sometimes occurs; some patients complain of headaches or dizziness. Weight gain is not typical for treatment with Esmya, but sometimes occurs. A common reaction is the appearance of acne on the face and increased sweating. Rare reactions include alopecia (baldness) and increased dry skin.

Other undesirable reactions are:

abdominal pain, nausea;
indigestion;
nose bleed;
increased gas formation, constipation;
pain in muscles, joints, back;
pelvic pain;
breast tension;
if there are cysts in the ovaries, they may rupture;
swelling;
increased fatigue, feeling of weakness.

Cysts in the ovaries formed during therapy are functional and do not pose a danger to the patient. During clinical trials, cysts appeared in 12% of women. They disappeared on their own after finishing the course.

In patients with large fibroids (with an enlarged uterus up to 12 weeks of pregnancy) and a history of frequent bleeding, uterine bleeding may occur during therapy or 2-3 months after its cessation.

Esmya has a contraceptive effect. It is implemented through the following processes:

structural changes in the endometrium that do not allow the embryo to implant;
blocking progesterone receptors;
inhibition of ovulation due to suppression of FSH release, follicles do not mature.

After cessation of therapy, menstrual function is quickly restored. Pregnancy can occur as early as the next cycle. This effect can be used in women with fibroids who could not become pregnant due to the presence of nodes.

Characteristics of the disease

Uterine fibroids are a so-called benign tumor that forms in any part of the uterine cavity. As a rule, it is diagnosed in reproductive females whose age exceeds 35 years and is characterized by the appearance of various disorders in the patient’s body. The following factors may contribute to the formation of a benign tumor:

presence of the disease in close relatives (hereditary predisposition);
inflammatory processes in the genitourinary system;
a sharp change in the level of hormones in the body;
the presence of other gynecological diseases;
traumatic effects on the abdominal area of various types;
pathological disorders in the cardiovascular and endocrine systems;
excess body weight;
progression of adenomyosis.

With a small size of the tumor, symptoms are usually limited to disruption of the menstrual cycle and mild malaise, but if there is a pathology with a large diameter, then the signs of its manifestation may be the following:

frequent pain that is localized in the lower abdomen;
the appearance of bloody clots in the female secretion;
disruption of the functioning of nearby vital organs;
disruptions of the menstrual cycle (delay, excessively long periods);
the occurrence of an unpleasant odor from the vagina;
sudden mood swings, severe emotional excitability;
swelling of the abdomen;
unnatural color of secretion;
all sorts of problems arise in the genitourinary system;
the functioning of the gastrointestinal tract worsens.

Once the above symptoms are detected, immediately contact the nearest medical facility for proper assistance to protect yourself from the development of adverse consequences.

For women who have not yet experienced such a pathology, qualified health workers strongly recommend undergoing a routine gynecological examination at least once a year. Such annual procedures will facilitate the rapid diagnosis of present diseases (if any) and ensure their timely treatment.

Features of eliminating the disease

Absolutely any (conservative or surgical) method of treating fibroids should be prescribed exclusively by the attending physician, who takes into account all the present characteristics of the female body. As a rule, when the size of the myomatous node is small, drug treatment is prescribed due to the intake of a drug containing hormones. The effect of the prescribed therapeutic method should be aimed at preventing the production of progesterone, which provokes an increase in the tumor, and at ensuring that the blood vessels do not deliver nutrients to the fibroid and it will soon stop growing and begin to decrease in diameter. To achieve the desired result and a speedy recovery, the victim must take the entire course of prescribed pharmacological agents and adhere to all established recommendations of an experienced doctor.

If conservative treatment is ineffective or when the size of the fibroid node is impressive, surgical intervention is prescribed, during which surgeons personally remove the benign tumor.

Who is contraindicated for treatment?

Contraindications for the use of Esmya are associated with conditions sensitive to progesterone concentrations.

Such conditions are pregnancy and breastfeeding. If a woman starts taking the pill early in her gestation, it can lead to a miscarriage. During lactation, the drug may be excreted in breast milk, but milk production itself is not affected.

Esmiya is not used in girls under 18 years of age due to the lack of data on effectiveness and safety. Other contraindications for treatment are:

hypersensitivity to the drug or its components;
vaginal bleeding that is not associated with fibroids;
severe bronchial asthma that does not respond to hormonal therapy;
oncological diseases: cervical, ovarian, breast cancer.

If a rash or skin itching appears during treatment, you should consult a doctor and stop taking the drug. Hypersensitivity reactions have not been reported but cannot be completely excluded.

Itching, yellowing of the eyes, bitterness in the mouth, and belching may be symptoms of liver damage. They can be confirmed using biochemical analysis or ultrasound. If such signs appear, medical attention is needed.

There was no overdose of Esmya. During a study on volunteers, a single dose of 200 mg or daily use of 50 mg of the drug did not lead to signs of overdose.

Side effects

CNS:

emotional disorders;
headache;
feeling of anxiety;
dizziness.

Gastrointestinal organs:

nausea;
abdominal pain;
dyspepsia;
flatulence;
dry mouth;
constipation.

Hearing organs:

vertigo.

Respiratory system:

nosebleeds.

Skin and subcutaneous tissues:

increased sweating ;
the appearance of acne ;
skin lesions.

Musculoskeletal system:

muscle and bone soreness
pain in the back area.

Genitourinary system and mammary glands:

amenorrhea;
urinary incontinence;
endometrial thickening;
metrorrhagia;
tides;
formation of ovarian cysts ;
pelvic pain;
soreness , enlargement , tension of the mammary glands ;
vaginal discharge;
rupture of an ovarian cyst.

Other:

weight gain;
increased fatigue;
swelling;
asthenia.

Laboratory readings:

increase in blood cholesterol and triglycerides .

During clinical studies, the most common side effects were observed, among which 10–15% were endometrial thickening , which in most cases goes away on its own after discontinuation of treatment; 12-13% - hot flashes ; 6.4% - mild or moderate headaches 1.5% - ovarian cysts , disappearing spontaneously over several weeks; uterine bleeding , which in some cases requires surgery.

What affects the effectiveness of therapy

Given the metabolism of ulipristal in the liver, taking drugs from other chemical groups may reduce the effectiveness of therapy. Also, while taking Esmya, the effectiveness of certain medications may also decrease.

In patients using combined hormonal agents for contraception, treatment results may worsen. COCs contain an estrogen and a progestogen component. When taken simultaneously with ulipristal, competition for progesterone receptors occurs. Therefore, during fibroid therapy, non-hormonal methods are prescribed for additional contraception.

It is not recommended to completely abandon the use of contraceptives. Esmya blocks ovulation, but there is a risk of pregnancy. Doctors advise switching to condoms and spermicides.

Some drugs affect the activity of liver enzymes involved in the metabolism of ulipristal. It is not recommended to carry out simultaneous treatment with Esmya and the following drugs:

Rifampicin;
Carbamazepine;
Phenytoin;
Phenobarbital;
Pyrimidon;
Efavirenz;
Nevirapine;
Ritonavir.

St. John's wort extract also accelerates the metabolism of ulipristal and reduces its effect. Decoctions for oral administration and any tinctures containing this plant cannot be used.

Absorption from the stomach may be affected by drugs that reduce acidity. The combined use of the proton pump inhibitor Esomeprazole and Esmya has been studied. It was noted that with long-term treatment of the stomach, the absorption of ulipristal decreases by 65%. This combination is not recommended, but short courses of treatment with Esomeprazole are allowed.

Manufacturers do not recommend taking the drug simultaneously with the following drugs:

grapefruit juice;
Eriromycin;
Verapamil;
Ketoconazole;
Itraconazole;
Clarithromycin.

Topical use of antifungal agents is not contraindicated.

In order not to nullify the effectiveness of Esmya therapy, a woman should warn her doctor about the medications she is taking for other diseases. It is possible that before starting treatment, you will need to consult a related specialist who will select another drug that will not negatively affect the treatment of fibroids.

Is it possible to use it together with the boron uterus?

Many patients try to find effective ways to treat fibroids among folk recipes, however, no herbs can change the causes of tumor formation. In any case, if you are going to take advantage of folk experience, you first need to discuss this method with your doctor. Thus, the use of St. John's wort is contraindicated in this case, and the same applies to a plant such as boron uterus. As you know, with its help it is possible to get rid of uterine bleeding and heavy menstruation. However, when treated with a drug such as Esmya, there is no menstruation at all, so the additional hemostatic effect of this plant can lead to undesirable consequences.

Comparison with other fibroid treatments

Esmya is a relatively new drug for the drug treatment of fibroids. Not all doctors use it, and due to the risk of liver damage, restrictions have been introduced on prescribing to new patients. But old methods of conservative therapy are also not always safe and have severe side effects.

Ginestril

Ginestril (mifepristone) is also a progesterone receptor blocker. Its additional effect is to compete for receptors with glucocorticoids. Ginestril is used to treat fibroids up to 12 weeks in size. Considering its non-selectivity and effect on corticosteroids, the list of contraindications is much wider than that of Esmya:

adrenal insufficiency;
porphyria;
chronic renal failure;
submucosal nodes;
long-term treatment with corticosteroids;
blood clotting disorders;
treatment with anticoagulants;
endometrial hyperplasia;
severe extragenital diseases;
heart rhythm disturbances;
chronic obstructive pulmonary disease;
severe hypertension;
chronic heart failure.

If you accidentally take more than 4 tablets, signs of overdose may appear in the form of adrenal dysfunction.

The side effects of Ginestril have not been fully studied. But it is known that during treatment endometrial hyperplasia, bleeding, headaches, and dyspeptic disorders may develop.

In patients with bronchial asthma, mifepristone reduces the effectiveness of glucocorticoids, which are used in the form of inhalation. Therefore, it is necessary to adjust the dose together with the therapist to prevent the occurrence of severe attacks.

Which is better, Ginestril or Esmiya?

In each case, the doctor must decide. The gynecologist will be guided by concomitant diseases that may be a contraindication for the use of mifepristone. Esmiya has fewer such contraindications.

But the use of Ginestril, like other medications for fibroids, gives only a temporary effect. During the tumor regression, the woman should become pregnant if this was the goal of preserving the uterus. For those preparing for surgery, it is performed as soon as possible after completion of the course.

Buserelin

The drug is a synthetic analogue of gonadotropin-releasing hormone. It acts through communication with hormone receptors in the anterior pituitary gland. After the start of use, after 2 weeks, the release of FSH and luteinizing hormone is inhibited. Along the chain, the work of the ovaries is inhibited. The amount of estrogen in the blood corresponds to the values after the onset of menopause.

This effect leads to inhibition of fibroid growth and its regression. But a sharp decrease in estrogen causes artificial menopause and its worst manifestations. The number of adverse reactions of Buserelin often makes it necessary to abandon its use. Most patients experience the following negative consequences:

headache;
mood swings;
sleep disorders;
feeling depressed and depressed;
decreased sex drive;
vaginal dryness;
pain during sexual intercourse;
pelvic pain;
nausea, vomiting, appetite disturbances;
tides;
nose bleed;
dry skin;
pain in bones, joints;
weakness in the legs, tingling in the hands.

When using Buserelin, the formation of ovarian cysts and uterine bleeding is possible. Swelling often appears on the legs. Joint pain is associated with impaired bone mineralization. Therefore, after a course of therapy with Buserelin, restorative treatment will be required to avoid pathological fractures. Considering the pronounced adverse reactions, the drug is prescribed in only one course for no more than 6 months.

Hot flashes and other signs of dysfunction of the autonomic nervous system can be very difficult to bear. Therefore, some women refuse drug treatment for fibroids when they learn about such adverse reactions. But they are excluded when using ulipristal. Therefore, in the dilemma of Buserelin or Esmiya, many doctors prefer to prescribe the second remedy.

Observations of the results after discontinuation of the drug also speak in favor of Esmya. In patients taking Buserelin and its analogs, a month after discontinuation, the size of the fibroids was restored to 17% of the original. This was not observed when using ulipristal. A repeated course allows you to achieve even better results, and maintenance treatment can preserve them for a long time.

Doctors' opinions and women's reviews about the drug Esmya for uterine fibroids

Uterine fibroids (leiomyoma, fibromyoma) are a hormone-dependent tumor that consists of connective and smooth muscle tissue cells.

Its size ranges from small nodules to large formations weighing more than 1 kg. Treatment tactics depend on the diameter of the tumor.

Esmya gives good results for uterine fibroids, which suppresses tissue proliferation. With timely diagnosis and treatment, the prognosis is favorable.

Characteristics of the disease

Uterine fibroids are a benign tumor that can be single or multiple. The size of myomatous nodes is usually compared with the size of the uterus at different stages of pregnancy. Large tumors are more often found in women of childbearing age. In postmenopause, their growth stops, after which their reverse development begins - involution.

According to statistics, myomatous nodes are detected in 20% of patients who consult a gynecologist with complaints of prolonged menstrual bleeding.

Causes of formation of myomatous nodes

Increased activity of the ovaries is one of the key reasons for the formation of tumors in the female reproductive organs. Excessive production of estrogen leads to hormonal imbalance and accelerated growth of the endometrium. The growth of myomatous nodes is provoked by:

abuse of hormonal contraceptives;
surgical termination of pregnancy;
endometriosis of the uterus;
ovarian cysts;
endocrine disorders;
inflammation of the fallopian tubes and gonads;
complicated course of pregnancy.

Myoma is one of the hormone-dependent tumors, therefore, with the natural decline of ovarian function, its growth stops.

Characteristic symptoms

Small myomatous nodules do not cause discomfort, so women do not make an appointment with a doctor. They are discovered by chance during a routine examination or when visiting a gynecologist for other reasons. As the size of the tumor increases, women have complaints about:

prolongation of menstrual bleeding;
menstrual irregularities;
pain in the lower abdomen;
release of blood clots.

Large neoplasms compress the surrounding anatomical structures - the end of the rectum, the urinary tract. Therefore, the clinical picture is replenished with new symptoms - chronic constipation, painful urination. Myomas larger than 20 weeks of pregnancy compress the inferior vena cava, so women are worried about shortness of breath and rapid heartbeat.

Myomatous nodes extremely rarely become malignant, but if not treated in a timely manner, the development of cancer cannot be ruled out.

Characteristics of the drug

The treatment tactics for hormone-dependent neoplasms depend on their size, severity of symptoms, and age of the patient. If the tumor is small, conservative therapy is used. It is based on medications that restore the functions of the sex glands - the ovaries.

Esmya is a drug from the group of synthetic progesterone receptor modulators, which has an antiprogesterone effect. Its active components directly affect the inner lining of the uterus - the endometrium. Systematic treatment of fibroids with Esmya leads to:

decrease in the level of female hormones in the blood;
normalization of ovarian function;
slowing down the division of cells of the smooth muscle tissue of the uterus;
regulated destruction (apoptosis) of the endometrium.

When taking the drug daily during the menstrual cycle, the next menstruation is preserved. But the next critical days come only after completion of hormonal therapy.

Compound

Esmya is a tablet for oral administration, each of which contains 5 mg of ulipristal. Additionally they include:

talc;
mannitol;
magnesium stearate;
MCC;
croscarmellose sodium.

The active substance belongs to the selective (selective) modulators of progesterone receptors. Ulipristal suppresses the growth of fibroids and affects the fertility of patients. According to reviews, the menstrual cycle is restored 1 month after stopping the course.

Release forms

Esmya is a hormonal medicine that comes in the form of convex white tablets. On one side there is an engraving - ES5. The tablets are packaged in blisters of 14 pieces. One cardboard package contains from 2 to 6 blisters, which corresponds to 28 and 84 tablets.

Indications for use

The drug Esmya is prescribed to women with increased activity of the gonads. Tablets are prescribed to eliminate:

small myomatous nodes;
heavy bleeding;
pain in the lower abdomen and lower back.

The medicine is additionally used before removing large fibroids to reduce their diameter.

Side effects

Esmya extremely rarely provokes serious adverse reactions. Most of them are transient in nature and disappear within a couple of days after completion of the course.

Undesirable effects from taking Esmya:

emotional disorders;
headache;
absence of menstruation;
soreness of the mammary glands;
spatial disorientation;
moderate abdominal pain;
mild to moderate hot flashes;
excessive sweating;
acne on the skin;
muscle and joint pain;
attacks of nausea;
vaginal discharge.

According to statistics, 10% of women with uterine fibroids experience thickening of the endometrium. But the symptom goes away a month after completion of therapy.

Contraindications to taking the drug

Esmya is prescribed to persons over 18 years of age. It is not used to treat fibroids if:

hypersensitivity to components;
bleeding from the vagina of unknown origin;
cancer of the mammary glands, ovaries, fallopian tubes;
gestation and lactation;
severe form of bronchial asthma.

Esmya should be taken with caution if you have liver or kidney failure. The course of therapy is not extended without a doctor’s recommendation.

Instructions for use

The medicine is taken in courses of up to 3 months. If necessary, therapy is repeated, but not earlier than the second menstrual cycle is completed.

Recommendations for taking Esmya:

daily dose – 5 mg (1 tablet);
frequency of administration – 1 time per day;
time of administration - regardless of food;
Course duration – no more than 3 months.

Gynecologists recommend taking the medicine at the same time. If you miss a pill, take it as quickly as possible.

Analogues of the drug

There are no structural analogues of Esmia on the pharmaceutical market. If necessary, the drug is replaced with drugs with similar pharmacological properties.

Non-structural analogues of Esmiya:

Miropriston;
Gynestyl;
Quinol;
Epigalin;
Stella;
Epigallate;
Decapeptyl;
Zoladex.

It is strictly not recommended to change the treatment regimen without a doctor’s recommendation. Self-medication is fraught with disease progression and complications.

Patient reviews

Many patients with uterine fibroids underwent conservative treatment with Esmya. Most of them are satisfied with the results of therapy and the absence of significant side effects.

Reviews about Esmiya for uterine fibroids:

Svetlana, 28 years old. When the doctor said that I had fibroids in my uterus the size of a walnut, I was simply stunned. After all, she hardly showed any symptoms, only her lower abdomen periodically hurt. The gynecologist prescribed Esmia for me and told me to take the pills continuously for 3 months. Then I went for an ultrasound and it turned out that the tumor had decreased by 1/3. So, girls, don’t rush to go under the knife right away. Maybe everything will work out!
Galina, 41 years old. I took Esmya for fibroids for about 2.5 months. During the examination, the tumor was not found, although at first they threatened to perform an operation. I didn’t feel any side effects, except for a headache. But it went away within a couple of days after the start of the course.
Lyudmila, 37 years old. I really hoped for Esmiya, and she even seemed to help. On the ultrasound, the doctor said that the tumor had become smaller. But then her growth resumed again. The doctor advised me to undergo a second course of treatment.
Olga, 33 years old. A year ago I was diagnosed with fibroids. The doctor prescribed Esmia for 3 months. Fortunately, the tumor has shrunk and some of it remains only on the surface of the uterus.

Negative reviews from women about treatment with ulipristal tablets are often associated with:

non-compliance with dosage;
premature interruption of therapy;
incorrect combination of tablets.

To achieve recovery, take the medicine strictly in accordance with the instructions or recommendations of your doctor.

Doctors' reviews about the drug

Specialists in the field of gynecology and women's reproductive health often use Esmya in their practice. Ulipristal tablets do not cause serious side effects and allow you to avoid surgery if fibroids are diagnosed early.

Tablets for fibroids are available in pharmacies without a prescription, but you should not take them without finding out the cause of vaginal bleeding.

Reviews from doctors about the medicine:

Oleg Mikhailov, gynecologist. For small fibroids that form in the body of the uterus, I prescribe Esmya to my patients. This is one of the few drugs that directly affects the endometrium and inhibits cell proliferation. In 8 out of 10 cases, after completing a course of therapy, surgical intervention is not required.
Elena Dobrynina, reproductive specialist. Recently, the number of women suffering from tumor diseases of the reproductive system has been growing. And this is due to the uncontrolled use of hormonal contraceptives. Fortunately, in the early stages the disease can be stopped with the drug Esmya. It induces apoptosis of cells in the uterus, and therefore the disease quickly regresses.
Olga Savitskaya, obstetrician-gynecologist. Many women with difficult pregnancies are subsequently diagnosed with fibroids. If the patient agrees to switch the child to formula feeding, I always recommend treatment with Esmya. Unlike many other drugs in this group, ulipristal is a low-toxic drug. It quickly restores the menstrual cycle and prevents anemia.

Gynecologists warn that conservative treatment of a hormone-dependent tumor is effective only if it is small in size. You should not postpone surgery for large fibroids - more than 12 weeks of pregnancy. Delayed treatment is fraught with complications - torsion of the tumor stalk, its prolapse through the cervix, and malignancy.

Esmya for endometriosis

Tablets with ulipristal have a direct effect on the rate of growth of the lining of the uterus - the endometrium. Therefore, they are often included in complex therapy for endometriosis. Regular use of the drug at a dose of 5 mg during 1 menstrual cycle leads to:

stopping uterine bleeding;
thinning of the endometrial layer;
reduction of pelvic pain during menstruation;
restoration of the menstrual cycle.

The drug prevents histological changes in the endometrium. It suppresses the proliferation (growth) of the mucous layer of the uterus.

After restoration of ovarian function, the level of estrogen in the blood does not exceed normal values. Therefore, endometriosis does not progress.

Price

Many patients complain that Esmya is very expensive. Its cost depends on the pricing policy of the pharmacy chain and the region of the country. On average, the price of one package varies from 8,200 to 10,000 rubles. But 1 pack of 84 tablets is enough for almost a full course of therapy.

Conclusion

Esmya is a drug based on ulipristal, which suppresses the growth of hormone-dependent tumors in the uterus. The therapeutic effect is achieved within 1-3 months of taking the tablets. With a course of medication, women manage to get rid of small tumors and avoid surgical intervention.

Source: https://ginekologius.ru/jesmija-otzyvy-pri-miome

Analogues of Esmiya

Selective progesterone receptor blockers are under development. At this stage, only ulipristal is used. Analogues of the drug Esmiya in composition are Dwella. The active ingredient in them is the same, the difference is in the dosage and severity of the effects.