title: Management of fibroids in perimenopausal women.
abstract: OBJECTIVE
  This article reviews fibroids management in the perimenopausal period, and addresses future directions in care.
  
  
  RESULTS
  Aromatase inhibitors, selective estrogen receptor modulators and antiprogestogens for medical management and minimally surgical techniques are promising treatments.
  
  
  CONCLUSIONS
  The disease and the symptoms may persist in the peri and postmenopausal periods. The assumption that they will resolve with the onset of the menopause is too simplistic and not always valid. The number of perimenopausal women who wish to retain their uterus for reasons other than childbearing is increasing. The accurate diagnosis of these conditions may result in minor surgical or medical treatments being directed at the specific pathology and may avoid the need for major surgery.
authors.affiliation: aDepartment of Clinical Science, Polytechnic University of Marche, Ancona bDepartment of Molecular and Developmental Medicine, Obstetrics, and Gynecology, University of Siena, Siena cDepartment of Experimental and Clinical Medicine, Faculty of Medicine dDepartment of Information Engineering, Polytechnic University of Marche, Ancona, Italy *Mario Castellucci and Pasquapina Ciarmela contributed equally to the writing of this article.
authors.forename: Stefano R
authors.initials: SR
authors.lastname: Giannubilo
authors.forename: Andrea
authors.initials: A
authors.lastname: Ciavattini
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
authors.forename: Mario
authors.initials: M
authors.lastname: Castellucci
authors.forename: Pasquapina
authors.initials: P
authors.lastname: Ciarmela
mesh_terms: D047072:Aromatase Inhibitors / Q000627:therapeutic use; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D047648:Perimenopause; D011372:Progestins / Q000037:antagonists & inhibitors*; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D014594:Uterine Neoplasms / Q000473:pathology / Q000628:therapy*; D014599:Uterus / Q000473:pathology*
chemical_list: D047072:Aromatase Inhibitors; D006727:Hormone Antagonists; D011372:Progestins; D020845:Selective Estrogen Receptor Modulators