title: Uterine fibroids: clinical manifestations and contemporary management.
abstract: Uterine fibroids (leiomyomata) are extremely common lesions that are associated with detrimental effects including infertility and abnormal uterine bleeding. Fibroids cause molecular changes at the level of endometrium. Abnormal regulation of growth factors and cytokines in fibroid cells may contribute to negative endometrial effects. Understanding of fibroid biology has greatly increased over the last decade. Although the current armamentarium of Food and Drug Administration-approved medical therapies is limited, there are medications approved for use in heavy menstrual bleeding that can be used for the medical management of fibroids. Emergence of the role of growth factors in pathophysiology of fibroids has led researchers to develop novel therapeutics. Despite advances in medical therapies, surgical management remains a mainstay of fibroid treatment. Destruction of fibroids by interventional radiological procedures provides other effective treatments. Further experimental studies and clinical trials are required to determine which therapies will provide the greatest benefits to patients with fibroids.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Reproductive Endocrinology and Infertility, Yale School of Medicine, New Haven, CT, USA leo.doherty@yale.edu.
authors.forename: Leo
authors.initials: L
authors.lastname: Doherty
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Reproductive Endocrinology and Infertility, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Levent
authors.initials: L
authors.lastname: Mutlu
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Reproductive Endocrinology and Infertility, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Sinclair
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Reproductive Endocrinology and Infertility, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Hugh
authors.initials: H
authors.lastname: Taylor
mesh_terms: D000818:Animals; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D019468:Disease Management; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000037:antagonists & inhibitors; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007889:Leiomyoma / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000379:methods; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000628:therapy*
chemical_list: D047072:Aromatase Inhibitors; D007987:Gonadotropin-Releasing Hormone
keywords: female infertility; growth factors; implantation; leiomyoma