Medical Treatment of Uterine Leiomyoma

Abstract

Uterine leiomyomas (also called myomata or fibroids) are the most common gynecologic tumors in the United States. The prevalence of leiomyomas is at least 3 to 4 times higher among African American women than in white women. Pathologically, uterine leiomyomas are benign tumors that arise in any part of the uterus under the influence of local growth factors and sex hormones, such as estrogen and progesterone. These common tumors cause significant morbidity for women and they are considered to be the most common indication for hysterectomy in the world; they are also associated with a substantial economic impact on health care systems that amounts to approximately $2.2 billion/year in the United States alone. Uterine myomas cause several reproductive problems such as heavy or abnormal uterine bleeding, pelvic pressure, infertility, and several obstetrical complications including miscarriage and preterm labor. Surgery has traditionally been the gold standard for the treatment of uterine leiomyomas and has typically consisted of either hysterectomy or myomectomy. In recent years, a few clinical trials have evaluated the efficacy of orally administered medications for the management of leiomyoma-related symptoms. In the present review, we will discuss these promising medical treatments in further detail.

Injectable Clostridium Histolyticum Collagenase as a Potential Treatment for Uterine Fibroids

“…These include oral and intramuscular contraceptives, estrogen and progesterone receptor modulators, gonadotropin-releasing hormone agonists, myomectomy, uterine artery embolization (UAE), high-intensity focused ultrasound (HIFU), and laparoscopic ultrasound-guided radiofrequency volumetric thermal ablation. [3][4][5][6][7] Targeted destruction methods induce necrosis, and hormonal treatments can affect fertility and are contraindicated in patients with certain comorbidities. [3][4][5][6][7] There would be an advantage to a minimally invasive fibroid treatment that does not induce necrosis and is nonhormonal.…”

Rapidly progressive, large nascent cervical myoma with intrauterine device – case report and review of literature

“…Apart from growing pain, also necrotic changes in the tumour, bleedings, and infections could be associated with a vaginally prolapsed, nascent fibroid, hence the treatment is obligatory. In such an emergent situation the medical (conservative) options could not be considered suitable (GnRH analogues or antagonists, selective oestrogen receptor modulators, or anti-progesterones), although useful in many other circumstances, particularly as pre-operative treatment [5].…”

Prescription patterns of Chinese herbal products for patients with uterine fibroid in Taiwan: A nationwide population-based study

“…Alternative therapies for the relief of uterine fibroid symptoms have been sought and evaluated for years (Mehl-Madrona, 2002;Sabry and Al-Hendy, 2012). Traditional Chinese medicine (TCM), including Chinese herbal products and acupuncture, is a commonly used alternative therapy to treat uterine fibroids (Liu et al, 2013;Zhang et al, 2010).…”