PHYSICIAN PRACTICE
Treatment of Uterine Fibroids should be tailored to the size and location of the tumors; the patient’s age, symptoms, desire to maintain fertility, and access to treatment; and the physician’s experience.
Treatment Options for UTERINE FIBROIDS

LIMITATION OF SURGICAL THERAPY
Hysterectomy
- Morbidity
- Risk of Surgical long-term complications
- Complete loss of fertility
Myomectomy
- Fibroid Recurrence
- Potential uterian repture during
- Pregnancy/delivery
Uterine-artery embolization (UAE)
- Fibroid Recurrence
- Pain
- Possibility of severe complication
- Possibility of subsequent hysterectomy in
20% cases
Magnetic Resonance-guided Focused Ultrasound
- High costs
- Needs interventional radiologist
- No sufficient data for fertility & subsequent
pregnancies
LIMITATION OF MEDICAL THERAPY (HORMONAL)
NSAIDs
- Lack of supportive evidence from clinical trials
- GI side effects & risk of gastric ulceration
Anit fibrinolytics TNX
- Can increase the size of myoma
- TNX: tranexamic acid
Androgens (Danazol)
- Cause acne hirsutism, edema
- Associated with liver toxicity
- Adverse effects on lipid metabolism & Wait gain
Aromatase Inhibitors (Al)
- Causes hypoestrogenic side effects.
- Insufficient evidence to support use of Al for Fibroid.
GNRH Agonist Leuprolide Triptorelin
- Causes hot flushes, vaginal dryness & decreased libido
- Increase bone mass loss; Increase risk of osteoporosis
Progestins
- Breakthrough bleeding
- Can increase size of myoma
Combined Oral Contraceptives (COC)
- Breakthrough bleeding
- Not safe for long term use
- Can increase size of myama