Uterine Fibroids and Progestogen Treatment: Lack of Evidence of Its Efficacy: A Review

Donnez, Jacques

doi:10.3390/jcm9123948

Cited by 25 publications

(16 citation statements)

References 78 publications

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“…While oral contraceptives and progestogens may curtail AUB in case of moderate disease, they do not reduce myoma size, and therefore have limited benefits for women with fibroid-related infertility. Moreover, it is clear that progesterone and progestogens promote myoma growth via several signaling pathways [ 1 , 2 , 3 , 4 , 5 , 46 ]. In a recent review, the absence of evidence on the effectiveness of treating premenopausal women with uterine fibroids with progestogens was clearly demonstrated [ 5 ].…”

Section: Apposite Medical Treatmentmentioning

confidence: 99%

“…Moreover, it is clear that progesterone and progestogens promote myoma growth via several signaling pathways [ 1 , 2 , 3 , 4 , 5 , 46 ]. In a recent review, the absence of evidence on the effectiveness of treating premenopausal women with uterine fibroids with progestogens was clearly demonstrated [ 5 ].…”

Section: Apposite Medical Treatmentmentioning

confidence: 99%

“…Uterine fibroids are the most commonly encountered benign uterine tumors [ 1 , 2 , 3 , 4 , 5 ]. They occur in 50–60% of women, rising to 70% by the age of 50.…”

Section: Introductionmentioning

confidence: 99%

“…They can cause heavy menstrual bleeding (HMB) with subsequent anemia, which could be life-threatening. Large myomas can also result in pressure symptoms (bulk symptoms) and bladder dysfunction, including increased daytime urinary frequency and urinary incontinence [ 1 , 2 , 3 , 4 , 5 ]. Dysmenorrhea and pelvic pain are often encountered, impacting quality of life and undermining daily activities [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Dysmenorrhea and pelvic pain are often encountered, impacting quality of life and undermining daily activities [ 12 , 13 ]. Abdominal distention and pelvic pressure on the ureters (causing hydronephrosis) may also interfere with quality of life [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Furthermore, uterine fibroids can cause infertility, depending on their location in the myometrium [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Conservative Management of Uterine Fibroid-Related Heavy Menstrual Bleeding and Infertility: Time for a Deeper Mechanistic Understanding and an Individualized Approach

Dolmans

Cacciottola

Donnez

2021

JCM

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(1) Background: Uterine fibroids are the most common form of benign uterine tumors, causing heavy menstrual bleeding (HMB), pelvic pain, infertility and pressure symptoms. Almost a third of women with uterine fibroids seek treatment. The objective of this review is to understand the mechanisms linking fibroids to these symptoms and evaluate different options for their management, particularly the place of gonadotropin-releasing hormone (GnRH) antagonist. (2) Methods: We gathered the most recent and relevant papers on the main fibroid-related symptoms and medical and surgical therapy for their treatment. Those reporting use of oral GnRH antagonists were investigated in detail. (3) Results: The mechanisms explaining myoma-related HMB and infertility were reviewed, as they are essential to a deeper mechanistic understanding and oriented approach. The choice of treatment depends on the number, size, and location of fibroids, and is guided by the patient’s age and desire to preserve her fertility. Economic impacts of myomas in terms of direct costs, lost workdays, and complications were found to be significant. Medical, surgical, and non-surgical strategies were analyzed in this context. Novel medical approaches with GnRH antagonist were explored and found to represent an effective new option. (4) Conclusion: The need for alternatives to surgical intervention is very real, especially for women seeking to preserve their fertility. New options now exist, with GnRH antagonists proven to treat fibroid symptoms effectively, opening the door to novel strategies for the management of myomas.

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Section: Apposite Medical Treatmentmentioning

confidence: 99%

Section: Apposite Medical Treatmentmentioning

confidence: 99%

“…Uterine fibroids are the most commonly encountered benign uterine tumors [ 1 , 2 , 3 , 4 , 5 ]. They occur in 50–60% of women, rising to 70% by the age of 50.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Conservative Management of Uterine Fibroid-Related Heavy Menstrual Bleeding and Infertility: Time for a Deeper Mechanistic Understanding and an Individualized Approach

Dolmans

Cacciottola

Donnez

2021

JCM

Self Cite

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Psychosocial Stress and MicroRNA Expression Profiles in Myometrial Tissue of Women Undergoing Surgical Treatment for Uterine Fibroids

Dye,

Wu,

VanNoy

et al. 2024

Reprod. Sci.

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Uterine leiomyomas ( broids) are the most common non-cancerous tumor affecting women. Psychosocial stress is associated with broid risk and severity. The relationship between psychosocial stress and broid pathogenesis may involve alterations in microRNAs (miRNAs) although this has yet to be examined. We investigated associations between two psychosocial stress measures, a composite measure of recent stressful life events and perceived social status, with expression levels of 401 miRNAs in myometrium (n = 20) and broids (n = 44; 20 matched between tissues) from pre-menopausal women who underwent surgery for broid treatment. We used linear regressions to identify psychosocial stressors associated with miRNAs, adjusting for covariates (age, body mass index, and race/ethnicity). Psychosocial stressors were modeled as ordinal variables and results were considered statistically signi cant if the overall variable signi cant was below false discovery threshold (FDR < 0.10) and showed a monotonic dose-response (nominal p-trend < 0.05). In the myometrium, 16 miRNAs were signi cantly associated with total stressful events and two miRNAs were associated with perceived social status. No broid miRNAs were associated with either stress measure. Pathway analyses revealed miRNA-mRNA targets were signi cantly enriched (FDR < 0.05) in pathways relevant to cancer/tumor development. Of the 74 differentially expressed miRNAs between myometrium and broids (p < 0.05), miR-27a-5p was also associated with stress exposure. Our pilot analysis suggests that psychosocial stress is associated with changes in myometrium miRNAs, and thus, plays a role in the pathogenesis of broids from healthy myometrium.

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Contraception et pathologies bénignes de l'utérus

Kolanska,

Chabbert-Buffet

2024

La Contraception en Pratique

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Uterine Fibroids and Progestogen Treatment: Lack of Evidence of Its Efficacy: A Review

Cited by 25 publications

References 78 publications

Conservative Management of Uterine Fibroid-Related Heavy Menstrual Bleeding and Infertility: Time for a Deeper Mechanistic Understanding and an Individualized Approach

Conservative Management of Uterine Fibroid-Related Heavy Menstrual Bleeding and Infertility: Time for a Deeper Mechanistic Understanding and an Individualized Approach

Psychosocial Stress and MicroRNA Expression Profiles in Myometrial Tissue of Women Undergoing Surgical Treatment for Uterine Fibroids

Contraception et pathologies bénignes de l'utérus

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