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The most frequent symptom with leiomyoma is menometrorrhagia. However, it can be responsible of pelvic pain, dysmenorrhea or urinary and digestive compression when it is particularly voluminous.
These recommandations were made in order to review medical management of fibroids. If no therapy is able to have them disappear, various drugs may reduce their related symptoms. Tranexamic acid, non-steroidal anti-inflammatory drugs and high dose of oestrogen may be useful in the management of acute hemorrhagic disorders.
Progestin, such as lynestrenol induces small reduction in leiomyoma volume and moderate increase in hemoglobin level before surgery. Pregnane and nor-pregnane may improve menstrual bleeding in short or mild delays. Add-back therapy using tibolone seems interesting since secondary effects encountered with GnRH agonists may be reduced. Levonorgestrel-releasing intrauterine system is proven to reduce increased menstrual bleeding and restore hemoglobin level. Aminoglutethimide and fadrozole have been underevaluated to conclude when letrozole seems as efficient as GnRH agonists to reduce leiomyoma volume and provide less hot flushes.
Anastrozol is associated with reduction in leiomyomata volume, pain and menstrual bleeding. Mifepristone reduces the size of uterine leiomyomata, improves symptomatology, but could be associated with development of endometrial hyperplasia. SPRM evaluated in females have shown to improve leiomyoma related symptomatology. Danazol could be useful to reduce leiomyoma related symptoms in short terms.
Tamoxifen and raloxifen show modest overall benefit. Because of insufficient data concerning fulvestrant, pirfenidone or interferon, their prescription cannot be recommended in patients with leiomyomata. Leiomyomata, Bleeding, Pelvic pain, Medical treatment. Chabbert-buffet b , S. Douvier c , C. Huchon d , E. Paganelli e , J. Outline Masquer le plan.
Manipulation pharmacologique des facteurs de croissance: Quelle contraception en cas de fibrome? Myome et traitement hormonal substitutif. Top of the page - Article Outline. The ontario uterine fibroid embolization trial. Clinical decision making regarding leiomyomata: Sex steroid receptors in human myometrium and fibroids: Influence of exogenous estrogen receptor ligands on uterine leiomyoma: Advances in uterine leiomyoma research: Treatment of menorrhagia during menstruation: Uterine artery blood flow parameters in women with dysfunctional uterine bleeding and uterine fibroids: Tranexamic acid-associated necrosis and intralesional thrombosis of uterine leiomyomas: Protective effect of depot-medroxyprogesterone acetate on surgically treated uterine leiomyomas: Medical management of uterine fibroids with medroxyprogesterone acetate Depo-Provera: Efficacy of pre-operative gonadotrophin hormone releasing analogues for women with uterine fibroids undergoing hysterectomy or myomectomy: The effectiveness of the levonorgestrel-releasing intrauterine system in menorrhagia: GnRH analogues and uterine leiomyomas.
Preoperative administration of GnRH-a plus tibolone to premenopausal women with uterine fibroids: Medroxyprogesterone acetate with Zoladex for long-term treatment of fibroids: Selective estrogen receptor modulators SERMs for uterine leiomyomas.
Cochrane Database Syst Rev Effectiveness of combined GnRH analogue plus raloxifene administration in the treatment of uterine leiomyomas: Will GnRH antagonists assist in the treatment of benign gynaecological diseases?
Presurgical short term treatment of uterine fibroids with different doses of cetrorelix acetate: Danazol for uterine fibroids. Gestrinone versus danazol as preoperative treatment for hysteroscopic surgery: Gestrinone in the treatment of uterine leiomyomata: Raloxifene administration in premenopausal women with uterine leiomyomas: Mifepristone for treatment of uterine leiomyoma.
Low-dose mifepristone in treatment of uterine leiomyoma: Effect of mifepristone for symptomatic leiomyomata on quality of life and uterine size: Mifepristone for the treatment of uterine leiomyomas: Selective progesterone receptor modulators and progesterone antagonists: Identification of new therapies for leiomyomas: Risk factors for uterine fibroids: Use of oral contraceptives and uterine fibroids: Uterine myoma in postmenopause: