Abstract
Background: The objective of this review is to determine the evidence or, conversely, the absence of evidence regarding the effectiveness of progestogens in treating premenopausal women with uterine fibroids. In particular, the goal is to address recurring questions as to whether they are effective or not for managing symptoms commonly attributed to fibroids. Methods: A review of the most relevant papers (n = 63) on the efficacy of progesterone and progestogens as medical therapy for uterine fibroids. Results: Having reviewed the most significant papers on the relationship between uterine fibroids and progesterone/progestogens, it is clear that there is biochemical, histological and clinical evidence that progesterone and progestogens play a critical role in the pathogenesis of myomas. Conclusion: Since progesterone is already implicated in the pathogenesis of this entity, using progestogens to manage fibroids is like constantly adding fuel to the fire, rendering this treatment ineffective.
Highlights
The prevalence of fibroids depends upon ethnic background [1,2]
In the presence of heavy menstrual bleeding (HMB) due to fibroids, it shows much more limited efficacy. These authors reported that mcoymompaarsedtretoattehde wpritohlifmereadtrivoexypphraosgee[s2t1e]r.one acetate (MPA) and norethindrone acetate (NETA) are approved in many countries for the treatment of various forms of “abnormal” uterine bleeding, but their long-term use in fibroid-related HMB is not currently supported by solid evidence, because of the absence of benefits reported in the literature [63]
This review demonstrates that leiomyoma growth is integrally regulated by the complex cross-talk between sex steroid hormones and growth factors
Summary
The prevalence of fibroids depends upon ethnic background [1,2]. It varies widely based on the diagnostic approach, but is estimated to be more than 60% in women over the age of 45 years [3–5]. While some fibroids are asymptomatic, others result in symptoms that warrant therapy [3,6]. The most common symptom is heavy menstrual bleeding (HMB), but pelvic pain, bulk symptoms and infertility are other frequent manifestations that may greatly affect the quality of life of these women [2,4,6,7]
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