18 April 2024 : Review article
[In Press] Advancements and Emerging Therapies in the Medical Management of Uterine Fibroids: A Comprehensive Scoping Review
Jarosław Krzyżanowski 1ABCDEF, Tomasz Paszkowski 1ADE, Piotr Szkodziak 1DE, Sławomir Woźniak 1ADEFDOI: 10.12659/MSM.943614
Med Sci Monit In Press; DOI: 10.12659/MSM.943614
Available online: 2024-04-18, In Press, Corrected Proof
Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule
Abstract
ABSTRACT
Uterine fibroids, benign tumors originating from uterine smooth muscle cells, vary in prevalence depending on patient ethnicity, hormonal exposure, and genetics. Due to their high incidence, these neoplasms pose a significant burden on healthcare systems. Current treatment strategies range from routine monitoring in asymptomatic cases to surgical procedures such as myomectomy or hysterectomy in symptomatic patients, with an increasing trend toward uterus-preserving or non-surgical alternatives. This review examines the existing medical treatments for uterine fibroids and delves into the potential of emerging therapies.
A scoping review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.
Medical therapies are divided into hormonal and non-hormonal treatments; however, long-term, safe, and effective treatments in the treatment of uterine fibroids are limited. In addition to established therapies, there is an increasing number of studies investigating the effect of substances such as vitamin D or green tea extract on uterine fibroids. Some studies investigate acupuncture as a possible alternative therapy.
While existing treatments offer symptomatic relief and preparation for surgery, our findings point to a significant need for further research into long-term solutions, especially owing to recent limitations in the use of ulipristal acetate due to risk of liver damage. Initial studies involving vitamin D and epigallocatechin gallate are encouraging; however, additional research is required to establish definitive therapeutic roles.
Keywords: Anti-Inflammatory Agents, Non-Steroidal; Drug Therapy; Gonadotropin-Releasing Hormone; Leiomyoma; Tranexamic Acid; Ulipristal Acetate
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