title: Role of Medical Management for Uterine Leiomyomas.
abstract: Uterine leiomyomas, or fibroids, are the most common benign tumor in reproductive aged women. Affected women may remain asymptomatic or may report symptoms related to abnormal uterine bleeding, infertility, or pelvic pain and pressure. Depending on a patient's symptomatology and reproductive plans, treatment options include expectant management, medical management (hormonal and non-hormonal), or surgical management (myomectomy or hysterectomy). In those wishing to defer surgical management, non-hormonal therapies such as non-steroidal anti-inflammatory drugs and tranexamic acid have been shown to decrease menstrual blood loss. In patients with more symptomatic leiomyomas, hormonal therapies such as gonadotropin-releasing hormone agonists and selective progesterone receptor modulators are effective at reducing leiomyoma volume, uterine size, and menstrual blood loss. This manuscript will detail the available and emerging hormonal and non-hormonal treatments for symptomatic uterine leiomyomas.
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, Rutgers, New Jersey Medical School, Newark, NJ, USA. Electronic address: banakashani@gmail.com.
authors.forename: Banafsheh N
authors.initials: BN
authors.lastname: Kashani
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Centini
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, Rutgers, New Jersey Medical School, Newark, NJ, USA.
authors.forename: Sara S
authors.initials: SS
authors.lastname: Morelli
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, Rutgers, New Jersey Medical School, Newark, NJ, USA.
authors.forename: Gerson
authors.initials: G
authors.lastname: Weiss
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D000077465:Cabergoline; D002762:Cholecalciferol / Q000627:therapeutic use; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000627:therapeutic use*; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use; D003280:Contraceptives, Oral, Synthetic / Q000627:therapeutic use; D003613:Danazol / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000627:therapeutic use; D004873:Ergolines / Q000627:therapeutic use; D004963:Estrenes / Q000627:therapeutic use; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D005867:Gestrinone / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors; D006801:Humans; D007436:Intrauterine Devices, Medicated; D007889:Leiomyoma / Q000188:drug therapy*; D016912:Levonorgestrel / Q000008:administration & dosage; D015735:Mifepristone / Q000627:therapeutic use; D009649:Norpregnadienes / Q000627:therapeutic use; D010091:Oximes / Q000627:therapeutic use; D010347:Patient Care Planning; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D013004:Somatostatin / Q000031:analogs & derivatives; D014148:Tranexamic Acid / Q000627:therapeutic use; D014594:Uterine Neoplasms / Q000188:drug therapy*; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D000933:Antifibrinolytic Agents; D047072:Aromatase Inhibitors; D003271:Contraceptive Agents, Female; D003278:Contraceptives, Oral, Hormonal; D003280:Contraceptives, Oral, Synthetic; D018491:Dopamine Agonists; D004873:Ergolines; D004963:Estrenes; D004965:Estrogen Antagonists; D009649:Norpregnadienes; D010091:Oximes; D020845:Selective Estrogen Receptor Modulators; D014815:Vitamins; D005867:Gestrinone; D002762:Cholecalciferol; D015735:Mifepristone; D007987:Gonadotropin-Releasing Hormone; D013004:Somatostatin; D016912:Levonorgestrel; D014148:Tranexamic Acid; C488516:asoprisnil; D000077465:Cabergoline; D003613:Danazol; C555622:ulipristal acetate
keywords: abnormal uterine bleeding; fibroids; medical management; uterine leiomyomas