Can Mifepristone be used to control excessive bleeding?

Question

Hi doctor,

My mother has large uterine fibroids, which are causing her to experience excessive bleeding. She is 50 years old and has a cardiac condition with an ejection fraction of 20 percent. Additionally, she has a history of high blood pressure (for over 15 years), recently diagnosed diabetes, and hypothyroidism (for more than a decade). The doctors have advised against surgery due to her medical issues. I have attached her reports. A gynecologist suggested Mifepristone but recommended that we confirm this with a cardiologist. Please suggest some medications or let us know if Mifepristone is safe to start. She urgently needs medication to stop the bleeding.

Currently, she is taking the following medications for her cardiac condition: Carvedilol 12.5 mg, Digoxin 0.25 mg, Torasemide 10 mg and 20 mg, Aspirin, and Telmisartan 40 mg. For the fibroids and bleeding, she is taking Danazol, Ferrous ascorbate and Folic acid supplements, Dicyclomine and Mefenamic acid , and Calcium supplements, among others. Her thyroxine and HbA1c levels are 50 mcg/dL and 9.3 percent, respectively. The HIV and HBs(AG) tests are non-reactive.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

I have reviewed all the reports (attachment removed to protect the patient's identity). Mifepristone can be very effective in reducing the size of the uterine fibroids and controlling the bleeding. However, initially, she may experience heavy bleeding when starting Mifepristone in combination with Aspirin, as bleeding is a potential side effect of the medication. I recommend starting Mifepristone at a low dosage and closely monitoring the severity of the bleeding. If she experiences significant and persistent bleeding, the dosage of Mifepristone should be further reduced. She must be under the supervision of her gynecologist. Please consult your specialist, discuss this with them, and begin the medication only with their consent.

I wish her a swift recovery.

Best regards.