Medical Management of Uterine Fibroids-A hope for Fertile Women!

Abstract

Uterine fibroids or Myomas or Leiomyoma of uterus are the most common type of benign tumor of uterus and most common pelvic tumour in women with unclear etiology. Uterine fibroids or Myomas or Leiomyoma of uterus are the most common type of benign tumor of uterus. In India the incidence of fibroids is most common in women of 31- 40 years of age i.e. as more than 1/3 (35%) of them get affected. Recent understanding of etiology suggests increased number of estrogen and Progesterone Receptors, increased COMT gene expression and TGF-B3. Risk factors for developing fibroids are age, early age at menarche, reduced fertility, frequent caffeine consumption, obesity, hypertension, diabetes mellitus, alcohol consumption and previous pelvic inflammatory disease (PID). Rural women are at a much higher risk of uterine fibroids than urban women in India. (37.65% vs.24%) probably due to multiparty at a young age disturbing Estrogen and Progesterone Receptors. Treatment options for symptomatic uterine fibroids include medical, surgical, and radiologically guided interventions. Although curative treatment relies on surgical therapies- either myomectomy or hysterectomy, medical treatments are considered the first-line treatment to preserve fertility and avoid or delay surgery. Medical therapy is in nascent stage in India. Medical treatment must be individualized based on age, signs & symptoms, sustained reduction of the size and sustenance of fertility if desired with minimal side effects. Materials and Methods: This article is based on a literature review on medical therapy being tried on a case the author is managing now. The initial results are encouraging and need to monitor the reduction of the size or volume of the Fibroid in coming months.