A patient came to OPD. She had undergone conservative myomectomy for a large fibroid. She was kept on dienogest 2 mg daily for 3 months post operation. Now she has finished dienogest 1.5 months back. Still no menses. She did TVS and 2 new small fibroids were found in uterus. Though during operation the surgeon had spent about 15 mins to look for new fibroids and had found none.
MRI had also stated 1 fibroid. 3 months before operation leuprorelin 11.5 mg was given. Can dienogest cause fibroids(high progesterone state)? Could leuprolide shrink the smaller fibroids and now they have grown after few months? Why are the menses not coming? What tests to order? Should MRI be done again?
