Objective: An observational case study to evaluate the efficacy and safety of UPA in patients who chooses UPA as the treatment protocol.

Method: Ulipristal acetate (UPA) administrated for 2 treatment course of 3 months which was 5 mg of daily oral ulipristal acetate for first 3 month treatment course and follow up monthly for monitoring the symptoms and fibroid volume. The second treatment course will start at the earliest during the second menstruation following the first treatment course completion.

Result: Preliminary data showed a marked reduction in intramural myoma volume after 3 months and 6 months courses of 5 mg UPA which is 18.5% and 29% respectively, while subserous myoma had a reduction of 14.5% of the total size. Our patients also experienced significant reduction in the symptoms of uterine bleeding with UPA. The endometrium was noted to be thickened during the treatment cycle but this thickening was normalized during the treatment free period. The main side effects reported were intermittent hot flushes, headache and lower abdominal pain which were not present after the first month of treatment.

Conclusion: UPA demonstrate the efficacy and safety profile in treatment of symptomatic uterine fibroid.