Shifting paradigms in uterine fibroids treatment: insights from current therapeutic approaches

Abstract

This review examined the effectiveness of ulipristal acetate (UPA) compared to leuprolide acetate (LEU) in the treatment of symptomatic uterine fibroids. The primary objective was to analyze relevant studies that investigated the improvement of symptoms, complications, alternative treatment options, and surgical outcomes for fibroids. Using the PICO format as a research approach, various aspects were compared for each treatment, including diagnostic accuracy, side effects, quality of life, and patient satisfaction measured through the Uterine fibroid symptoms and quality of life scale. UPA proved to be a safe, well-tolerated, and effective treatment option for symptomatic uterine fibroids, leading to amenorrhea and reduced heavy menstrual bleeding. On the other hand, LEU also effectively reduced fibroid size but had a higher incidence of adverse events such as hot flashes, vaginal dryness, and decreased bone density. It is crucial to consider all the aforementioned factors when selecting the most suitable treatment option for individual patients, as each treatment has its own advantages and disadvantages, including dosing requirements, side effects, endometrial changes, and their impact on treatment adherence and outcomes. Currently, there is limited evidence supporting the superiority of UPA over other drugs like LEU in short-term therapy for symptomatic uterine fibroids. Further research is necessary to establish UPA as a reliable and promising alternative. Treatment decisions should be individualized, taking into account patient comorbidities and considering both surgical and conservative approaches.