title: An Evidence-based Approach to the Medical Management of Fibroids: A Systematic Review.
abstract: Fibroids are the most common tumor of the female reproductive tract, but approved medical treatments are limited. Patients demand uterine-sparing treatments which preserve fertility and avoid surgery. We systematically reviewed PubMed and Cochrane databases from January 1985 to November 2015 for evidence-based medical therapies for fibroids in the context of disease prevention, treatment of early disease, treatment of symptomatic disease, and preoperative management. We identified 2182 studies, of which 52 studies met inclusion and exclusion criteria. Published data affirm the efficacy of multiple agents, which are promising avenues for the development of medical alternatives to surgery.
authors.affiliation: *Department of Obstetrics and Gynecology University of Connecticut School of Medicine, Farmington, Connecticut †Department of Gynecology and Obstetrics, Howard W and Georgeanna Seegar Jones Division of Reproductive Sciences and Women's Health Research, Johns Hopkins University School of Medicine, Baltimore, Maryland ‡Department of Obstetrics, Gynecology and Women's Health, University of Louisville School of Medicine, Louisville, Kentucky §Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio ∥Foxhall OB/GYN Associates, Washington, District of Columbia.
authors.forename: Chantal B
authors.initials: CB
authors.lastname: Bartels
authors.forename: Kamaria C
authors.initials: KC
authors.lastname: Cayton
authors.forename: Farah S
authors.initials: FS
authors.lastname: Chuong
authors.forename: Kristine
authors.initials: K
authors.lastname: Holthouser
authors.forename: Sara E
authors.initials: SE
authors.lastname: Arian
authors.forename: Tara
authors.initials: T
authors.lastname: Abraham
authors.forename: James H
authors.initials: JH
authors.lastname: Segars
mesh_terms: D000728:Androgens / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use; D003474:Curcumin; D003692:Delayed-Action Preparations; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D004958:Estradiol / Q000031:analogs & derivatives / Q000627:therapeutic use; D004963:Estrenes / Q000627:therapeutic use; D065171:Estrogen Receptor Antagonists / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005260:Female; D000077267:Fulvestrant; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D007436:Intrauterine Devices, Medicated; D007889:Leiomyoma / Q000188:drug therapy* / Q000517:prevention & control; D016912:Levonorgestrel / Q000627:therapeutic use; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D015735:Mifepristone / Q000627:therapeutic use; D020360:Neoadjuvant Therapy; D009649:Norpregnadienes / Q000627:therapeutic use; D010091:Oximes / Q000627:therapeutic use; D010936:Plant Extracts / Q000627:therapeutic use*; D011980:Receptors, Progesterone / Q000037:antagonists & inhibitors; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D013662:Tea; D063186:Uterine Myomectomy; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000517:prevention & control; D014807:Vitamin D / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D000728:Androgens; D047072:Aromatase Inhibitors; D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D003692:Delayed-Action Preparations; D004365:Drugs, Chinese Herbal; D004963:Estrenes; D065171:Estrogen Receptor Antagonists; D006727:Hormone Antagonists; D009649:Norpregnadienes; D010091:Oximes; D010936:Plant Extracts; D011980:Receptors, Progesterone; D020845:Selective Estrogen Receptor Modulators; D013662:Tea; D014815:Vitamins; D014807:Vitamin D; C461063:telapristone acetate; D000077267:Fulvestrant; D015735:Mifepristone; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D016912:Levonorgestrel; C488516:asoprisnil; D017258:Medroxyprogesterone Acetate; D003474:Curcumin; C555622:ulipristal acetate