Journal Maturitas today announced the publication of a position statement by the European Menopause and Andropause Society (EMAS) on the topic of the management of uterine fibroids.
Uterine fibroids (also termed leiomyomas or myomas) are the most common tumors of the female reproductive tract. While they may be asymptomatic they can cause abnormal bleeding, pelvic pressure symptoms and infertility. Fibroid growth and regression vary throughout life. Thus, they tend to grow during the reproductive years and regress after the menopause. They affect millions of women and are the leading cause of hysterectomy.
The traditional management of symptomatic fibroids has been surgery (hysterectomy or myomectomy). However, some women do not want invasive surgery and wish to retain their uterus and fertility. Fortunately, during the last few years new medical and surgical uterine-conserving alternatives have become available as technological advances have been made. The range of medical treatments allows flexible management of fibroid-related symptoms; the options include tranexamic acid, non-steroidal anti-inflammatory drugs, contraceptive steroids, gonadotropin-releasing hormone analogues, antiprogesterone, and selective progesterone receptor modulators. Alternatives to surgery include uterine artery embolization, myolysis and ablation by high-intensity focused ultrasound (guided with magnetic resonance imaging or ultrasound). The choice of treatment depends on fibroid size, the underlying symptoms and their severity and the woman's desire for subsequent fertility and pregnancy, as well as efficacy and need for repeated interventions.
These and other recommendations presented in EMAS' position statement are published in the article, "EMAS Position statement: Management of uterine fibroids" by, Faustino R. Pérez-López, Lía Ornat, Iuliana Ceausu, Herman Depypere, C. Tamer Erel, Irene Lambrinoudaki, Karin Schenck-Gustafsson, Tommaso Simoncini, Florence Tremollieres and Margaret Rees.
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"EMAS Position statement: Management of uterine fibroids" by, Faustino R. Pérez-López, Lía Ornat, Iuliana Ceausu, Herman Depypere, C. Tamer Erel, Irene Lambrinoudaki, Karin Schenck-Gustafsson, Tommaso Simoncini, Florence Tremollieres and Margaret Rees. www.maturitas.org/article/S0378-5122(14)00198-4/abstract