Role of Medical Management for Uterine Leiomyomas
Uterine leiomyomas, or fibroids, are the most common benign tumor in reproductive aged women. Affected women may remain asymptomatic or may report symptoms related to abnormal uterine bleeding, infertility, or pelvic pain and pressure. Depending on a patient’s symptomatology and reproductive plans,...
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| Veröffentlicht in: | Best practice & research. Clinical obstetrics & gynaecology 2016-07, Vol.34, p.85-103 |
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| container_title | Best practice & research. Clinical obstetrics & gynaecology |
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| creator | Kashani, Banafsheh N., MD Centini, Gabriele, MD Morelli, Sara S., MD Weiss, Gerson, MD Petraglia, Felice, MD |
| description | Uterine leiomyomas, or fibroids, are the most common benign tumor in reproductive aged women. Affected women may remain asymptomatic or may report symptoms related to abnormal uterine bleeding, infertility, or pelvic pain and pressure. Depending on a patient’s symptomatology and reproductive plans, treatment options include expectant management, medical management (hormonal and non-hormonal), or surgical management (myomectomy or hysterectomy). In those wishing to defer surgical management, non-hormonal therapies such as non-steroidal anti-inflammatory drugs and tranexamic acid have been shown to decrease menstrual blood loss. In patients with more symptomatic leiomyomas, hormonal therapies such as gonadotropin-releasing hormone agonists and selective progesterone receptor modulators are effective at reducing leiomyoma volume, uterine size, and menstrual blood loss. This manuscript will detail the available and emerging hormonal and non-hormonal treatments for symptomatic uterine leiomyomas. |
| doi_str_mv | 10.1016/j.bpobgyn.2015.11.016 |
| format | Article |
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Affected women may remain asymptomatic or may report symptoms related to abnormal uterine bleeding, infertility, or pelvic pain and pressure. Depending on a patient’s symptomatology and reproductive plans, treatment options include expectant management, medical management (hormonal and non-hormonal), or surgical management (myomectomy or hysterectomy). In those wishing to defer surgical management, non-hormonal therapies such as non-steroidal anti-inflammatory drugs and tranexamic acid have been shown to decrease menstrual blood loss. In patients with more symptomatic leiomyomas, hormonal therapies such as gonadotropin-releasing hormone agonists and selective progesterone receptor modulators are effective at reducing leiomyoma volume, uterine size, and menstrual blood loss. This manuscript will detail the available and emerging hormonal and non-hormonal treatments for symptomatic uterine leiomyomas.</description><identifier>ISSN: 1521-6934</identifier><identifier>EISSN: 1532-1932</identifier><identifier>DOI: 10.1016/j.bpobgyn.2015.11.016</identifier><identifier>PMID: 26796059</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>abnormal uterine bleeding ; Antifibrinolytic Agents - therapeutic use ; Aromatase Inhibitors - therapeutic use ; Cholecalciferol - therapeutic use ; Contraceptive Agents, Female - administration & dosage ; Contraceptive Agents, Female - therapeutic use ; Contraceptives, Oral, Hormonal - therapeutic use ; Contraceptives, Oral, Synthetic - therapeutic use ; Danazol - therapeutic use ; Dopamine Agonists - therapeutic use ; Ergolines - therapeutic use ; Estrenes - therapeutic use ; Estrogen Antagonists - therapeutic use ; Female ; fibroids ; Gestrinone - therapeutic use ; Gonadotropin-Releasing Hormone - agonists ; Gonadotropin-Releasing Hormone - antagonists & inhibitors ; Humans ; Intrauterine Devices, Medicated ; Leiomyoma - drug therapy ; Levonorgestrel - administration & dosage ; medical management ; Mifepristone - therapeutic use ; Norpregnadienes - therapeutic use ; Obstetrics and Gynecology ; Oximes - therapeutic use ; Patient Care Planning ; Selective Estrogen Receptor Modulators - therapeutic use ; Somatostatin - analogs & derivatives ; Tranexamic Acid - therapeutic use ; uterine leiomyomas ; Uterine Neoplasms - drug therapy ; Vitamins - therapeutic use</subject><ispartof>Best practice & research. Clinical obstetrics & gynaecology, 2016-07, Vol.34, p.85-103</ispartof><rights>Elsevier Ltd</rights><rights>2015 Elsevier Ltd</rights><rights>Copyright © 2015 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-f74790624be2df508aeccc292403ea6786638b428bc8006af660ef9d40dd97f13</citedby><cites>FETCH-LOGICAL-c467t-f74790624be2df508aeccc292403ea6786638b428bc8006af660ef9d40dd97f13</cites><orcidid>0000-0002-2731-3459</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1521693415002308$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26796059$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kashani, Banafsheh N., MD</creatorcontrib><creatorcontrib>Centini, Gabriele, MD</creatorcontrib><creatorcontrib>Morelli, Sara S., MD</creatorcontrib><creatorcontrib>Weiss, Gerson, MD</creatorcontrib><creatorcontrib>Petraglia, Felice, MD</creatorcontrib><title>Role of Medical Management for Uterine Leiomyomas</title><title>Best practice & research. Clinical obstetrics & gynaecology</title><addtitle>Best Pract Res Clin Obstet Gynaecol</addtitle><description>Uterine leiomyomas, or fibroids, are the most common benign tumor in reproductive aged women. Affected women may remain asymptomatic or may report symptoms related to abnormal uterine bleeding, infertility, or pelvic pain and pressure. Depending on a patient’s symptomatology and reproductive plans, treatment options include expectant management, medical management (hormonal and non-hormonal), or surgical management (myomectomy or hysterectomy). In those wishing to defer surgical management, non-hormonal therapies such as non-steroidal anti-inflammatory drugs and tranexamic acid have been shown to decrease menstrual blood loss. In patients with more symptomatic leiomyomas, hormonal therapies such as gonadotropin-releasing hormone agonists and selective progesterone receptor modulators are effective at reducing leiomyoma volume, uterine size, and menstrual blood loss. This manuscript will detail the available and emerging hormonal and non-hormonal treatments for symptomatic uterine leiomyomas.</description><subject>abnormal uterine bleeding</subject><subject>Antifibrinolytic Agents - therapeutic use</subject><subject>Aromatase Inhibitors - therapeutic use</subject><subject>Cholecalciferol - therapeutic use</subject><subject>Contraceptive Agents, Female - administration & dosage</subject><subject>Contraceptive Agents, Female - therapeutic use</subject><subject>Contraceptives, Oral, Hormonal - therapeutic use</subject><subject>Contraceptives, Oral, Synthetic - therapeutic use</subject><subject>Danazol - therapeutic use</subject><subject>Dopamine Agonists - therapeutic use</subject><subject>Ergolines - therapeutic use</subject><subject>Estrenes - therapeutic use</subject><subject>Estrogen Antagonists - therapeutic use</subject><subject>Female</subject><subject>fibroids</subject><subject>Gestrinone - therapeutic use</subject><subject>Gonadotropin-Releasing Hormone - agonists</subject><subject>Gonadotropin-Releasing Hormone - antagonists & inhibitors</subject><subject>Humans</subject><subject>Intrauterine Devices, Medicated</subject><subject>Leiomyoma - drug therapy</subject><subject>Levonorgestrel - administration & dosage</subject><subject>medical management</subject><subject>Mifepristone - therapeutic use</subject><subject>Norpregnadienes - therapeutic use</subject><subject>Obstetrics and Gynecology</subject><subject>Oximes - therapeutic use</subject><subject>Patient Care Planning</subject><subject>Selective Estrogen Receptor Modulators - therapeutic use</subject><subject>Somatostatin - analogs & derivatives</subject><subject>Tranexamic Acid - therapeutic use</subject><subject>uterine leiomyomas</subject><subject>Uterine Neoplasms - drug therapy</subject><subject>Vitamins - therapeutic use</subject><issn>1521-6934</issn><issn>1532-1932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUFv1DAQha0K1Ja2PwGUI5eEGTtx7AsIVUArbYUE9Gw5zrjyksSLna20_55Eu3DgwmlGozfvab5h7DVChYDy3bbqdrF7OkwVB2wqxGqZnrFLbAQvUQv-Yu05llKL-oK9ynkLIITmzTm74LLVEhp9yfBbHKiIvnigPjg7FA92sk800jQXPqbicaYUJio2FOJ4iKPN1-ylt0Omm1O9Yo-fP_24vSs3X7_c337clK6W7Vz6tm41SF53xHvfgLLknOOa1yDIylZJKVRXc9U5BSCtlxLI676GvtetR3HF3h59dyn-2lOezRiyo2GwE8V9NqigVaoWyBdpc5S6FHNO5M0uhdGmg0EwKy2zNSdaZqVlEM0yXfbenCL23Uj9360_eBbBh6OAlkOfAyWTXaDJLawSudn0Mfw34v0_Dm4I00r6Jx0ob-M-TQtFgyZzA-b7-rL1Y9gAcAFK_AZY25Ea</recordid><startdate>20160701</startdate><enddate>20160701</enddate><creator>Kashani, Banafsheh N., MD</creator><creator>Centini, Gabriele, MD</creator><creator>Morelli, Sara S., MD</creator><creator>Weiss, Gerson, MD</creator><creator>Petraglia, Felice, MD</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2731-3459</orcidid></search><sort><creationdate>20160701</creationdate><title>Role of Medical Management for Uterine Leiomyomas</title><author>Kashani, Banafsheh N., MD ; Centini, Gabriele, MD ; Morelli, Sara S., MD ; Weiss, Gerson, MD ; Petraglia, Felice, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-f74790624be2df508aeccc292403ea6786638b428bc8006af660ef9d40dd97f13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>abnormal uterine bleeding</topic><topic>Antifibrinolytic Agents - therapeutic use</topic><topic>Aromatase Inhibitors - therapeutic use</topic><topic>Cholecalciferol - therapeutic use</topic><topic>Contraceptive Agents, Female - administration & dosage</topic><topic>Contraceptive Agents, Female - therapeutic use</topic><topic>Contraceptives, Oral, Hormonal - therapeutic use</topic><topic>Contraceptives, Oral, Synthetic - therapeutic use</topic><topic>Danazol - therapeutic use</topic><topic>Dopamine Agonists - therapeutic use</topic><topic>Ergolines - therapeutic use</topic><topic>Estrenes - therapeutic use</topic><topic>Estrogen Antagonists - therapeutic use</topic><topic>Female</topic><topic>fibroids</topic><topic>Gestrinone - therapeutic use</topic><topic>Gonadotropin-Releasing Hormone - agonists</topic><topic>Gonadotropin-Releasing Hormone - antagonists & inhibitors</topic><topic>Humans</topic><topic>Intrauterine Devices, Medicated</topic><topic>Leiomyoma - drug therapy</topic><topic>Levonorgestrel - administration & dosage</topic><topic>medical management</topic><topic>Mifepristone - therapeutic use</topic><topic>Norpregnadienes - therapeutic use</topic><topic>Obstetrics and Gynecology</topic><topic>Oximes - therapeutic use</topic><topic>Patient Care Planning</topic><topic>Selective Estrogen Receptor Modulators - therapeutic use</topic><topic>Somatostatin - analogs & derivatives</topic><topic>Tranexamic Acid - therapeutic use</topic><topic>uterine leiomyomas</topic><topic>Uterine Neoplasms - drug therapy</topic><topic>Vitamins - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kashani, Banafsheh N., MD</creatorcontrib><creatorcontrib>Centini, Gabriele, MD</creatorcontrib><creatorcontrib>Morelli, Sara S., MD</creatorcontrib><creatorcontrib>Weiss, Gerson, MD</creatorcontrib><creatorcontrib>Petraglia, Felice, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Best practice & research. 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Depending on a patient’s symptomatology and reproductive plans, treatment options include expectant management, medical management (hormonal and non-hormonal), or surgical management (myomectomy or hysterectomy). In those wishing to defer surgical management, non-hormonal therapies such as non-steroidal anti-inflammatory drugs and tranexamic acid have been shown to decrease menstrual blood loss. In patients with more symptomatic leiomyomas, hormonal therapies such as gonadotropin-releasing hormone agonists and selective progesterone receptor modulators are effective at reducing leiomyoma volume, uterine size, and menstrual blood loss. 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| subjects | abnormal uterine bleeding Antifibrinolytic Agents - therapeutic use Aromatase Inhibitors - therapeutic use Cholecalciferol - therapeutic use Contraceptive Agents, Female - administration & dosage Contraceptive Agents, Female - therapeutic use Contraceptives, Oral, Hormonal - therapeutic use Contraceptives, Oral, Synthetic - therapeutic use Danazol - therapeutic use Dopamine Agonists - therapeutic use Ergolines - therapeutic use Estrenes - therapeutic use Estrogen Antagonists - therapeutic use Female fibroids Gestrinone - therapeutic use Gonadotropin-Releasing Hormone - agonists Gonadotropin-Releasing Hormone - antagonists & inhibitors Humans Intrauterine Devices, Medicated Leiomyoma - drug therapy Levonorgestrel - administration & dosage medical management Mifepristone - therapeutic use Norpregnadienes - therapeutic use Obstetrics and Gynecology Oximes - therapeutic use Patient Care Planning Selective Estrogen Receptor Modulators - therapeutic use Somatostatin - analogs & derivatives Tranexamic Acid - therapeutic use uterine leiomyomas Uterine Neoplasms - drug therapy Vitamins - therapeutic use |
| title | Role of Medical Management for Uterine Leiomyomas |
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