Efektivitas Pemberian Simvastatin 20 Mg terhadap Perubahan Ukuran Mioma Uteri

Abstract

Background. Uterine fibroids are benign growths in the uterus made of smooth muscle cells, fibroblasts, and Extracellular Matrix (ECM). They develop and respond to hormonal changes in women between puberty and menopause, causing symptoms like heavy menstrual bleeding, anemia, enlarged uterus, urinary or gastrointestinal issues, bloating, and pain. Simvastatin is a drug that inhibits the enzyme HMG-CoA reductase, which is involved in cholesterol synthesis. Simvastatin has been found to inhibit cell growth and induce apoptosis in uterine fibroid cells by affecting ERK and AKT activation. In xenograft mouse models, simvastatin decreased tumor volume in fibroid tissues, suggesting it as a potential treatment for uterine fibroids. Method. This is a quasi-experimental study with pre and post study approach to evaluate the effect on uterine fibroid size reduction after administering Simvastatin 20 mg for 12 weeks in Prof. dr. CPL USU Hospital and Stella Maris Maternal and Children Hospital. Consecutive sampling was used as the sampling technique in this study. Results. From 35 sample, based on age, majority of subjects were on group age 41-50 years, totaling 19 samples (54.3%), based on BMI, majority of subjects had obesity, accounting for 25 samples (71.4%), and based on parity status, majority of subjects were nulliparous, accounting for 14 samples (40%). Majority of samples had one uterine fibroid lesion, 23 patients (65.7%), while the most frequent location of uterine fibroid was the corpus, 23 patients (65.7%) with the type of uterine fibroid that is most often found being submucosa, 14 patients (40%). Before simvastatin 20mg administration, median size of uterine fibroid was 69.92 cm while after administration of simvastatin 20 mg it was 25.34 cm3 (p<0.001). The median decrease in uterine fibroid volume was 0.5 cm3. In this study, 11 patients (31.4%) experienced side effects such as myalgia and no other side effects were found. Conclusion. Majority of the samples were on group age of 41-50 years, had obesity, and nulliparous. We found a size reduction of uterine fibroids after administering simvastatin 20mg for 12 weeks were 2.43 cm3 (p < 0.001), Myalgia was the only side effect after simvastatin 20 mg administration reported in this study.