Abstract

Leiomyomas, also known as uterine fibroids, are a common benign tumor in women of reproductive age. These lesions disrupt the function of the uterus causing menorrhagia and pelvic pressure as well as reproductive disorders. These women pose a true challenge for clinicians in the attempt of choosing the suitable treatment for each patient. Patient's age, interest in fertility preservation, and leiomyoma location and size are all factors to be taken into account when deciding upon the preferable therapeutic option. For the past few decades, surgical treatment was the only reliable long-term treatment available. A variety of surgical approaches have been developed over the years but these developments have come at the expense of other treatment options. The classical medical treatment includes gonadotropin-releasing hormone (GnRH) agonists and antagonists. These agents are well known for their limited clinical effect as well as their broad spectrum of side effects, inspiring a need for new pharmacological treatments. In recent years, promising results have been reported with the use of selective progesterone receptor modulators (SPRM). Long-term clinical trials have shown a reduction in bleeding and shrinkage of leiomyoma mass. These results instill hope for women suffering from symptomatic leiomyomas seeking an effective, long-term medical option for their condition.

Highlights

  • Uterine leiomyomas, called fibroids, are the most common form of benign gynecological tumors [1, 2]

  • Leiomyomas characteristically present as well encapsulated fibrotic tissue within the wall of the uterus occurring in 77% of all women with a higher incidence in African-American women [3,4,5,6]

  • Enhancement of extracellular matrix (ECM) deposition plays an important role in the formation of uterine fibroids [24]

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Summary

Introduction

Called fibroids, are the most common form of benign gynecological tumors [1, 2]. The most recognized risk factors for the development of leiomyomas are early menarche, nulliparity, increased frequency of menses, history of dysmenorrhea, family history of leiomyomas, African descent, obesity, age (peak incidence at 40–50), and medical conditions such as diabetes and hypertension [8,9,10,11]. Behavioral attitudes such as diet with high consumption of meat or alcohol can increase the risk, as opposed to smoking that decreases the risk [12,13,14]. We review these new pharmacological modalities and the opportunities they offer to a large population of women in need of alternative medical treatments

Etiology
Surgical Therapy
Findings
Medical Therapy
Full Text
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