Ulipristal Acetate Prior to Surgery for Endometriosis

Sukhbir S Singh, Devon Evans, Shannen McDonald, Mary K. Senterman, Mary Senterman, Sarah Strickland
Reproductive sciences (Thousand Oaks, Calif.) · 2020 · vol. 27(9) , pp. 1707–1714 · doi:10.1007/s43032-020-00146-1 · PMID:32006245 · W3006040240
article OA: closed CC0 ⤵ 9 in-corpus citations
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-09 ⓘ

This review examined ulipristal acetate's effects on endometriosis lesions and symptoms, finding amenorrhea in 73% of patients and pain reduction in 92%, with PAEC observed in 58% of endometrial specimens.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This paper reviewed the effects of the selective progesterone receptor modulator ulipristal acetate (UPA) given before surgery in 15 women with endometriosis, assessing changes in eutopic endometrium and endometriotic lesions using pathology review by two gynecologic pathologists. Over 6–24 months (intermittent for most patients, continuous for 27%), 73% reported amenorrhea and 92% of the 12 patients with pain reported pain reduction or resolution; PAEC (pathologic progesterone receptor modulator-associated endometrial changes) was identified in 58% (7/12 with eutopic endometrium specimens). Among 14 patients who proceeded to surgery and had 49 extraovarian sites sampled, endometriosis was definitively identified in 63% of sites, and PAEC-like morphologic features were seen in 21% of cases, confined to cases where PAEC was also present in the endometrium. The authors conclude PAECs may occur in endometriosis lesions in UPA-treated patients, while further prospective work is needed to evaluate efficacy and safety; this study is limited by its small case series design without a prospective control group. This paper is centrally about endometriosis — it evaluates ulipristal acetate’s pre-surgical effects on endometriosis symptoms and lesion pathology, including PAEC-related findings.

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Condition tags

endometriosis

MeSH descriptors

Contraceptive Agents, Hormonal Endometriosis Norpregnadienes Adult Combined Modality Therapy Contraceptive Agents, Hormonal Endometriosis Endometriosis Endometriosis Endometrium Endometrium Female Humans Middle Aged Norpregnadienes Treatment Outcome

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