Myoma Uteri

myomauteri-1-0-25kapak

Medical Treatment of Uterine Leiomyomas

Hande Balaban1
Esra Aktepe Keskin2

1Ankara Medipol University, Private Middle East Hospital, Department of Gynecology and Obstetrics, Ankara, Türkiye
2 Ankara Medipol University, Private Middle East Hospital, Department of Gynecology and Obstetrics, Ankara, Türkiye

Balaban H, Aktepe Keskin E. Medical Treatment of Uterine Leiomyomas. Yavuz AF, ed. Myoma Uteri. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.61-70.

ABSTRACT

Treatment options for leiomyomas vary. The important point is to make an appropriate treatment de- cision by evaluating the severity of symptoms, the age of patient, proximity to menopause, future fertility desire of the women; location, size, and condition of the leiomyoma(s). Medical treatment of leiomyomas is based on two main purposes. One of these is to relieve leiomyoma-related symptoms such as excessive menstrual bleeding and the development of anemia as a result and dysmenorrhea, and the other is to reduce the size of the myoma preoperatively or to relieve symptoms related to myomas. For these reasons some medications such as Gonadotropin-Releasing Hormone (GnRH) an- alogs, GnRH antagonists, non-steroid anti-inflammatory drugs, tranexamic acid, progestin agents (oral or releasing intrauterine device), progesterone inhibitors, combined oral contraceptive pills, selective estrogen receptor modulators, aromatase inhibitors and androgens were developed. The general goal of treatment is to improve the symptoms (including abnormal uterine bleeding, pain, and pressure). Reducing leiomyoma size with GnRH analogs before surgery in patients desiring fertility with large myomas is another method. For patients with myomas who do not wish to use hormonal methods or continuous medication, tranexamic acid may be given for use during bleeding. The most important point is individualization of the treatment strategies based on the features of the patient.

Keywords: ULeiomyoma; Medical treatment; GnRH analog; Progestin; Tranexamic acid

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