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Although gonadotropin-releasing hormone (GnRH) agonist analogues effectively reduce tumor size in women with symptomatic uterine fibroids, profound hypoestrogenism and high costs associated with these medications limit their use. In a small nonblinded 12-week clinical trial, performed in Iran and Germany, investigators randomized women (mean age, 31) with single fibroids ≥5 cm and no other fibroids ≥2 cm to the oral aromatase inhibitor (AI) letrozole (Femara; 2.5 mg daily) or the injectable GnRH agonist triptorelin (3.75 mg monthly).
Of 60 evaluable women, total estimated fibroid volume declined by similar degrees in the AI and GnRH agonist groups (46% and 33%, respectively). No women who received letrozole reported hot flashes; 96% of those…