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Does the Use of Postmenopausal Hormone Replacement Therapy Influence the Size of Uterine Leiomyomata? A Preliminary Report

&NA; To determine if the use of hormone replacement therapy (HRT) in postmenopausal women influences the size of uterine leiomyomas, we report a series of 14 cases of postmenopausal women with uterine leiomyomas that were monitored with transvaginal pelvic ultrasound before and then at a mean of 19.7 ± 6.3 months after initiating HRT. A small group of seven postmenopausal women with uterine leiomyomas not treated with HRT were also evaluated at two time points (9.6 ± 1.7 months apart). There were no significant changes in mean uterine or myoma volumes from the time of the initial to follow‐up ultrasound in the postmenopausal women treated with HRT. Neither the type of estrogen or progestin preparation nor the HRT regimen (sequential versus continuous combined) affected the mean uterine or myoma volume. There were also no significant changes in the mean myoma volume in the small group of postmenopausal women not on HRT during this interval of time: however, the mean uterine volume decreased. The use of HRT in postmenopausal women with uterine leiomyomas does not seem to significantly increase uterine or myoma size, but may prevent the overall uterine size from shrinking postmenopausally. although larger prospectively designed studies are needed to confirm these findings. Therefore, perhaps following the less timeconsuming sonographic measurement of the overall uterine volume is adequate, and may be even preferable, for monitoring these patients rather than using the more labor‐intensive serial measurement of the volume of each individual myoma.