A Review of Treatment Options Available for Women with Uterine Fibroids
T. C. Okeke, C. C. T. Ezenyeaku, L. C. Ikeako
Journal of Advances in Medicine and Medical Research · pp. 1136–1148 · Published 28 Jan 2015
10.9734/BJMMR/2015/15880Abstract
Background: The quest for ideal treatment and understanding of fibroid biology has resulted in further studies in pharmacological, radiological and surgical options with the goals of being safe, less invasive, cost-effective and enhancing reproductive potentials. However, surgery remains the mainstay of present effective management for large symptomatic fibroids. Aim: The aim is to review the treatment options available for women with uterine fibroids. Methods: Publications on the management of uterine fibroids were accessed using medline, google scholar and pubmed databases. Relevant materials on treatment of uterine fibroids, selected references from internet services, journals, textbooks and lecture notes on management of uterine fibroids were also accessed and critically reviewed. Results: The mainstay of management for large symptomatic fibroids is surgical (myomectomy or hysterectomy). Minimally invasive procedures are becoming more commonly performed via both laparoscopic or hysteroscopic approaches, minimizing recovery time, postoperative pain and morbidity. Uterine artery embolization (UAE) carries a risk of pelvic infection with limited evidence regarding the risks for future pregnancies. Levonorgestrel-releasing intrauterine system (LNG-IUS) is effective as a treatment for heavy menstrual bleeding. However, it is not recommended if the uterine cavity is markedly enlarged or distorted by fibroids. Gonadotrophin releasing hormone analogue (GnRHa) is the most widely used medical option. It can reduce the size of fibroids by about 30-35%, but only used for short-term course or preoperative mode of management since the resulting hypoestrogenic state can cause osteoporosis in long-term course. Furthermore, it can restore haemoglobin levels and apparently reduce blood loss at operation but notorious for rebound growth of fibroids upon cessation of therapy with major adverse effects. Newly introduced treatment options are poorly understood, still unclear with lots of theoretical advantages not fully backed with long-term effects. Little is known about their risks, cost and adverse effects. Conclusion: Fibroids are commonly found in women of reproductive age. Most women do not require treatment because fibroids are benign and most times asymptomatic. For symptomatic fibroids, many treatment options exist and should be considered before the decision to perform hysterectomy which precludes future fertility.
References (89)
- 1 Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing leiomyoma.
- 2 Fertility and obstetric outcome after laparoscopic myomectomy of large myomata: a randomized comparison with abdominal myomectomy [DOI]
- 3 High-Intensity Focused Ultrasound: Current Potential and Oncologic Applications [DOI]
- 4 Fibroids and Infertility: A Systematic Review of the Evidence [DOI]
- 5 Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids [DOI]
- 6 Magnetic resonance-guided focused ultrasound surgery for uterine fibroids: relationship between the therapeutic effects and signal intensity of preexisting T2-weighted magnetic resonance images [DOI]
- 7 Vitamin D and the Risk of Uterine Fibroids [DOI]
- 8 Pregnancy outcomes after treatment for fibromyomata: uterine artery embolization versus laparoscopic myomectomy [DOI]
- 9 Systematic Review of Mifepristone for the Treatment of Uterine Leiomyomata [DOI]
- 10 Fertility after hysteroscopic myomectomy [DOI]
- 11 Treatment of symptomatic uterine fibroids with green tea extract: a pilot randomized controlled clinical study [DOI]
- 12 RETRACTED: Submucous myomas and their implications in the pregnancy rates of patients with otherwise unexplained primary infertility undergoing hysteroscopic myomectomy: a randomized matched control study [DOI]
- 13 Regression of uterine leiomyomata in response to the antiprogesterone RU 486 [DOI]
- 14 The Maine Womenʼs Health Study [DOI]
- 15 Laparoscopic Versus Open Myomectomy: A Double-Blind Study to Evaluate Postoperative Pain [DOI]
- 16 Comparability of perioperative morbidity between abdominal myomectomy and hysterectomy for women with uterine leiomyomas [DOI]
- 17 Modern management of uterine fibroids [DOI]
- 18 Green tea extract inhibits proliferation of uterine leiomyoma cells in vitro and in nude mice [DOI]
- 19 Traditional Surgical Approaches to Uterine Fibroids: Abdominal Myomectomy and Hysterectomy [DOI]
- 20 The effect of a levonorgestrel-releasing intrauterine device in the treatment of myoma-related menorrhagia [DOI]
- 21 Selective estrogen receptor modulators (SERMs) for uterine leiomyomas [DOI]
- 22 Antiproliferative and proapoptotic effects of epigallocatechin gallate on human leiomyoma cells [DOI]
- 23 Rapid reduction of leiomyoma volume during treatment with the GnRH antagonist ganirelix [DOI]
- 24 Image-Guided Thermal Therapy of Uterine Fibroids [DOI]
- 25 Magnetic resonance imaging-guided focused ultrasound ablation of uterine fibroids: early clinical experience [DOI]
- 26 Long-term effectiveness and safety of GnRH agonist plus raloxifene administration in women with uterine leiomyomas [DOI]
- 27 Ultrasound-Guided Radiofrequency Thermal Ablation of Uterine Fibroids: Medium-Term Follow-Up [DOI]
- 28 Percutaneous Sonographically Guided Radiofrequency Ablation of Medium-Sized Fibroids: Feasibility Study [DOI]
- 29 An image‐guided high intensity focused ultrasound device for uterine fibroids treatment [DOI]
- 30 The gynecologic contribution to intestinal obstruction in females.
- 31 Role of Hormonal and Reproductive Factors in the Etiology and Treatment of Uterine Leiomyoma [DOI]
- 32 Regression of Uterine Leiomyomata in Response to the Antiprogesterone RU 486 [DOI]
- 33 GnRH agonists and uterine leiomyomas [DOI]
- 34 Pharmacotherapeutic Effects of Kuei-chih-fu-ling-wan (Keishi-bukuryo-gan) on Human Uterine Myomas [DOI]
- 35 A comparison of laparoscopic supracervical hysterectomy and total abdominal hysterectomy outcomes [DOI]
- 36 Transvaginal radiofrequency thermal ablation: A day‐care approach to symptomatic uterine myomas [DOI]
- 37 Magnetic Resonance-Guided Percutaneous Cryoablation of Uterine Fibroids: Early Clinical Experiences [DOI]
- 38 Laparoscopic Ultrasound-Guided Radiofrequency Ablation of Uterine Fibroids [DOI]
- 39 Ulipristal Acetate [DOI]
- 40 [Low-dose combination oral contraceptives use in women with uterine leiomyomas].
- 41 GnRH agonists before surgery for uterine leiomyomas. A review.
- 42 Short-Term Treatment of Uterine Fibromyomas with Danazol [DOI]
- 43 Prospective randomised trial comparing gonadotrophin‐releasing hormone analogues with triple tourniquets at open myomectomy [DOI]
- 44 Bone Mass Reduction after Estrogen Deprivation by Long-Acting Gonadotropin-Releasing Hormone Agonists and Its Relation to Pretreatment Serum Concentrations of 1,25-Dihydroxyvitamin D3 [DOI]
- 45 Mr image‐guided control of cryosurgery [DOI]
- 46 What is the place of uterine artery embolisation in the management of symptomatic uterine fibroids? [DOI]
- 47 Uterine artery ligation for the treatment of fibroids [DOI]
- 48 Advances in the management of uterine fibroids [DOI]
- 49 Hysteroscopic endometrial ablation without endometrial preparation [DOI]
- 50 Hysterectomies Amongst Teenagers in Calabar, Nigeria [DOI]
- 51 Fibroids and infertility: an updated systematic review of the evidence [DOI]
- 52 Etiology, symptomatology, and diagnosis of uterine myomas [DOI]
- 53 Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow up [DOI]
- 54 Complications of hysteroscopy: a prospective, multicenter study [DOI]
- 55 Vitamin D and African Americans [DOI]
- 56 Growth of uterine leiomyomata among premenopausal black and white women [DOI]
- 57 Pregnancy After Uterine Artery Embolization for Leiomyomata: [DOI]
- 58 Hysteroscopic myomectomy: a comprehensive review of surgical techniques [DOI]
- 59 Uterine Fibroids: Uterine Artery Embolization versus Abdominal Hysterectomy for Treatment—A Prospective, Randomized, and Controlled Clinical Trial [DOI]
- 60 Complications of hysteroscopic surgery: predicting patients at risk [DOI]
- 61 Low-Dose Mifepristone for Uterine Leiomyomata [DOI]
- 62 Protective effect of depot‐medroxyprogesterone acetate on surgically treated uterine leiomyomas: a multicentre case‐control study [DOI]
- 63 Medical management of fibroids [DOI]
- 64 Fundamental Neurological Research and Human Neurosurgery Using Intense Ultrasound [DOI]
- 65 ACOG Committee Opinion #293: Uterine Artery Embolization [DOI]
- 66 Gonadotrophin-Releasing Hormone and Magnetic-Resonance–Guided Ultrasound Surgery for Uterine Leiomyomata [DOI]
- 67 Early outcome of myomectomy by laparotomy, minilaparotomy and laparoscopically assisted minilaparotomy. A randomized prospective study [DOI]
- 68 Transvaginal ultrasound-guided radiofrequency myolysis for uterine myomas [DOI]
- 69 Medical management of uterine fibroids with medroxyprogesterone acetate (Depo Provera): a pilot study [DOI]
- 70 Gestrinone in the treatment of uterine leiomyomata: Effects on uterine blood supply [DOI]
- 71 Obstetrics and Gynaecology - an Evidence Based Text for Mrcog
- 72 A placebo-controlled trial of a depot gonadotropin-releasing hormone analogue (leuprolide) in the treatment of uterine leiomyomata.
- 73 Role of leuprolide acetate depot in hysteroscopic surgery: a controlled study [DOI]
- 74 Does Low-Dose Combination Oral Contraceptive Use Affect Uterine Size or Menstrual Flow in Premenopausal Women With Leiomyomas? [DOI]
- 75 Complementary medicine treatment of uterine fibroids: a pilot study.
- 76 Myoma coagulation (myolysis) [DOI]
- 77 Ulipristal acetate in uterine fibroids [DOI]
- 78 Reproductive outcome after laparoscopic myomectomy in infertile women.
- 79 Myomectomy and MRI-Directed Cryotherapy [DOI]
- 80 Green tea extract inhibits proliferation of uterine leiomyoma cells in vitro and in nude mice [DOI]
- 81 Mifepristone: Clinical Application in General Gynecology [DOI]
- 82 Uterine artery embolisation for symptomatic fibroids [DOI]
- 83 Uterine Artery Embolization Versus Hysterectomy in the Treatment of Symptomatic Uterine Fibroids: 10 Years’ Outcomes From the Randomized EMMY Trial [DOI]
- 84 Does Low-Dose Combination Oral Contraceptive Use Affect Uterine Size or Menstrual Flow in Premenopausal Women With Leiomyomas? [DOI]
- 85 Expectant and medical management of uterine fibroids [DOI]
- 86 Update on Management of Uterine Fibroid
- 87 The cochrane database of systematic reviews [DOI]
- 88 Protective effect of depot‐medroxyprogesterone acetate on surgically treated uterine leiomyomas: a multicentre case‐control study [DOI]
- 89 Selective estrogen receptor modulators (SERMs) for uterine leiomyomas [DOI]
Cited by 6
Karima Abubakar Tunau, Jamila Abubakar Garba, Abubakar Abubakar Panti · Nigerian Postgraduate Medical Journal · 2021
Adebayo Ayoade Adekunle, Mumini Wemimo Rasheed, Najeem Adedamola Idowu · Journal of Diagnostic and Academic Pathology · 2024
Shahinaz Mahmood Shalaby, Mostafa K. Khater, Aymara Mas Perucho · Fertility and Sterility · 2016
Showing 3 of 6 known citations — external sources report more than can currently be individually listed.
Related research
- Pattern of Hearing Impairment in a Tertiary Institution in Ado Ekiti, Nigeria — shares topic coverage
- Weight Gain as Tuberculosis Treatment Regimen Progresses in Patients Receiving Antituberculosis Therapy — shares topic coverage
- TREAT-B has Good Accuracy in Selecting HBV Infected Patients for Treatment in Sudan — shares topic coverage
- Botox Treatment: A Comprehensive Review — shares topic coverage
- Harnessing Artificial Intelligence in Healthcare Analytics: From Diagnosis to Treatment Optimization — shares topic coverage
Article metrics
Real usage data collected on this platform.
66
Page views
0
PDF downloads
33
Outbound clicks
6
Citations
Views over time
Views by country
Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".
Traffic sources
Referring site, by host.
Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.