[Relation between hormonal therapy and tibolone with SERMs in postmenopausal women's myomes growth]

Myomas (both leiomyomas and fibromas) are the most frequent benign uterine tumors in women, they can be found in 77% of hysterectomy specimens. There are reports that previous hormonal therapy (estrogen-progestin), more than five years, is associated with high risk (fourfold higher) of leiomyomas. A study in patients without myomas demonstrated this type tumors production (5%) after receiving transdermical-oral hormonal combination during 24 months, and they were absent in patients with only oral therapy. Hormonal therapy increases size and quantity of myomas, or has a neutral effect. This therapy looks like having a higher effect in myoma growth. Tibolone has a neutral effect in myoma volume, and typical doses of raloxifene have no influence in its growth. If postmenopausal women with myomas need some therapy to control symptoms, hormonal therapy is not the best option; however, in asymptomatic patients tibolone is more suitable and raloxifene can be prescribed.