Under what conditions is uterine myoma in women of reproductive age associated with the use of combined oral contraceptives?

Uterine myoma (UM) is a common benign tumor of smooth muscle cells of the myometrium, which is often associated with metabolic disorders. Hormonal contraceptives are used to control the duration and volume of menstrual bleeding in UM. At the same time, data on the relationship between the use of combined oral contraceptives (COCs) and uterine myoma are contradictory.
The aim. To identify the relationship between uterine fibroids and the use of combined oral contraceptives in women of reproductive age, taking into account their ethnicity and the presence of metabolic disorders.
Materials and methods. The results of a re-analysis of a cross-sectional study conducted earlier in Eastern Siberia (2016–2019) are presented. A total of 1347 women of reproductive age (34.33 ± 6.37 years) were included in the study, of which 198 participants had uterine fibroids. The study methods included a questionnaire survey, general clinical and gynecological examinations, pelvic ultrasound, and statistical analysis.
Results. It was found that an increase in the likelihood of detecting uterine fibroids is associated with the use of COCs in the presence of metabolic syndrome and only in the Caucasian subpopulation (OR 3.287; 95% CI (1.490; 7.253)). The use of COCs is a factor associated with uterine fibroids in women with a BMI of more than 30 kg/m2, due to the subpopulation of Caucasian ethnicity, for whom the likelihood of having uterine fibroids is 6 times higher when using COCs than when not using COCs (OR 6.253, 95% CI (1.857; 21.054)). For Caucasians, the association between COC use and uterine fibroids was also demonstrated in patients with a BMI of less than 25 kg/m2 (OR 2.521; 95% CI (1.255; 5.064).
Conclusion. In women of reproductive age, the association between uterine fibroids and the use of combined oral contraceptives is observed in women of Caucasian ethnicity. The presence of metabolic disorders is a key co-factor in the association between uterine fibroids and the use of hormonal contraceptives.

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