title: Current management of myomas: the place of medical therapy with the advent of selective progesterone receptor modulators.
abstract: OBJECTIVE
  To review the current management of myomas with the advent of selective progesterone receptor modulators.
  
  
  RESULTS
  Selective progesterone receptor modulators have proved effective and recent publications on the use of ulipristal acetate (UPA) have analyzed the performance of long-term intermittent utilization of 10 mg UPA given in repeated courses of 3 months. This long-term intermittent therapy maximizes the efficacy of UPA. Indeed, control of bleeding is achieved sooner after each course. With each subsequent course, a statistically greater number of patients show a fibroid volume reduction of more than 50%.
  
  
  CONCLUSIONS
  The choice of therapy is influenced by different factors, such as the severity of symptoms, tumor characteristics, age, and wish to preserve the uterus (and fertility). Use of UPA will undoubtedly modify the surgical approach.
authors.affiliation: aSRI, Société de Recherche pour l'Infertilité, Brussels, Belgium bPregLem SA, Plan-les-ouates, Switzerland cPôle de Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Woluwe-Saint-Lambert, Brussels, Belgium dPolyclinique Urbain V, Avignon, France eCliniques Universitaires Saint-Luc, Service de Gynécologie, Bruxelles, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Donnez
authors.forename: Pablo
authors.initials: P
authors.lastname: Arriagada
authors.forename: Olivier
authors.initials: O
authors.lastname: Donnez
authors.forename: Marie-Madeleine
authors.initials: MM
authors.lastname: Dolmans
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D059247:Fertility Preservation; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009649:Norpregnadienes / Q000008:administration & dosage*; D018579:Patient Selection; D011980:Receptors, Progesterone / Q000819:agonists; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery
chemical_list: D018931:Antineoplastic Agents, Hormonal; D009649:Norpregnadienes; D011980:Receptors, Progesterone; D007987:Gonadotropin-Releasing Hormone; C555622:ulipristal acetate