The modern management of uterine fibroids-related abnormal uterine bleeding

Uterine fibroids (UFs) are the most common female benign pelvic tumors, affecting >60% of patients aged 30-44 years. Uterine fibroids are asymptomatic in a large percentage of cases and may be identified incidentally using a transvaginal ultrasound or a magnetic resonance imaging scan. However, i...

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Authors: Vannuccini, S, Petraglia, F, Carmona, F, Calaf, J, Chapron, C
Format: article
Status:Published version
Publication Date:2024
Country:España
Institution:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repository:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p18167
Online Access:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=18167
http://ddd.uab.cat/record/308097
Access Level:Open access
Keyword:Abnormal uterine bleeding
GnRH agonists
heavy menstrual bleeding
iron de fi ciency anemia
myomectomy
oral GnRH
antagonists
uterine fi broids
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spelling The modern management of uterine fibroids-related abnormal uterine bleedingVannuccini, SPetraglia, FCarmona, FCalaf, JChapron, CAbnormal uterine bleedingGnRH agonistsheavy menstrual bleedingiron de fi ciency anemiamyomectomyoral GnRHantagonistsuterine fi broidsUterine fibroids (UFs) are the most common female benign pelvic tumors, affecting >60% of patients aged 30-44 years. Uterine fibroids are asymptomatic in a large percentage of cases and may be identified incidentally using a transvaginal ultrasound or a magnetic resonance imaging scan. However, in approximately 30% of cases, UFs affect the quality of life and women's health, with abnormal uterine bleeding and heavy menstrual bleeding being the most common complaints, along with iron deficiency (ID) and ID anemia. Medical treatments used for UFs-related abnormal uterine bleeding include symptomatic agents, such as nonsteroidal antiinflammatory drugs and tranexamic acid, and hormonal therapies, including combined oral contraceptives, gonadotropin-releasing hormone agonists or antagonists, levonorgestrel intrauterine systems, selective progesterone receptor modulators, and aromatase inhibitors. Nevertheless, few drugs are approved specifically for UF treatment, and most of them manage the symptoms. Surgical options include fertility-sparing treatments, such as myomectomy, or nonconservative options, such as hysterectomy, especially in perimenopausal women who are not responding to any treatment. Radiologic interventions are also available: uterine artery embolization, high-intensity focused ultrasound or magnetic resonance-guided focused ultrasound, and radiofrequency ablation. Furthermore, the management of ID and ID anemia, as a consequence of acute and chronic bleeding, should be taken into account with the use of iron replacement therapy both during medical treatment and before and after a surgical procedure. In the case of symptomatic UFs, the location, size, multiple UFs, or coexistent adenomyosis should guide the choice with a shared decision-making process, considering long- and short-term treatment goals expected by the patient, including pregnancy desire or wish to preserve the uterus independently of reproductive goals.ELSEVIER SCIENCE INC2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=18167http://ddd.uab.cat/record/308097FERTILITY AND STERILITYISSN: 00150282ISSNe: 15565653reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p181672026-06-14T12:41:47Z
dc.title.none.fl_str_mv The modern management of uterine fibroids-related abnormal uterine bleeding
title The modern management of uterine fibroids-related abnormal uterine bleeding
spellingShingle The modern management of uterine fibroids-related abnormal uterine bleeding
Vannuccini, S
Abnormal uterine bleeding
GnRH agonists
heavy menstrual bleeding
iron de fi ciency anemia
myomectomy
oral GnRH
antagonists
uterine fi broids
title_short The modern management of uterine fibroids-related abnormal uterine bleeding
title_full The modern management of uterine fibroids-related abnormal uterine bleeding
title_fullStr The modern management of uterine fibroids-related abnormal uterine bleeding
title_full_unstemmed The modern management of uterine fibroids-related abnormal uterine bleeding
title_sort The modern management of uterine fibroids-related abnormal uterine bleeding
dc.creator.none.fl_str_mv Vannuccini, S
Petraglia, F
Carmona, F
Calaf, J
Chapron, C
author Vannuccini, S
author_facet Vannuccini, S
Petraglia, F
Carmona, F
Calaf, J
Chapron, C
author_role author
author2 Petraglia, F
Carmona, F
Calaf, J
Chapron, C
author2_role author
author
author
author
dc.subject.none.fl_str_mv Abnormal uterine bleeding
GnRH agonists
heavy menstrual bleeding
iron de fi ciency anemia
myomectomy
oral GnRH
antagonists
uterine fi broids
topic Abnormal uterine bleeding
GnRH agonists
heavy menstrual bleeding
iron de fi ciency anemia
myomectomy
oral GnRH
antagonists
uterine fi broids
description Uterine fibroids (UFs) are the most common female benign pelvic tumors, affecting >60% of patients aged 30-44 years. Uterine fibroids are asymptomatic in a large percentage of cases and may be identified incidentally using a transvaginal ultrasound or a magnetic resonance imaging scan. However, in approximately 30% of cases, UFs affect the quality of life and women's health, with abnormal uterine bleeding and heavy menstrual bleeding being the most common complaints, along with iron deficiency (ID) and ID anemia. Medical treatments used for UFs-related abnormal uterine bleeding include symptomatic agents, such as nonsteroidal antiinflammatory drugs and tranexamic acid, and hormonal therapies, including combined oral contraceptives, gonadotropin-releasing hormone agonists or antagonists, levonorgestrel intrauterine systems, selective progesterone receptor modulators, and aromatase inhibitors. Nevertheless, few drugs are approved specifically for UF treatment, and most of them manage the symptoms. Surgical options include fertility-sparing treatments, such as myomectomy, or nonconservative options, such as hysterectomy, especially in perimenopausal women who are not responding to any treatment. Radiologic interventions are also available: uterine artery embolization, high-intensity focused ultrasound or magnetic resonance-guided focused ultrasound, and radiofrequency ablation. Furthermore, the management of ID and ID anemia, as a consequence of acute and chronic bleeding, should be taken into account with the use of iron replacement therapy both during medical treatment and before and after a surgical procedure. In the case of symptomatic UFs, the location, size, multiple UFs, or coexistent adenomyosis should guide the choice with a shared decision-making process, considering long- and short-term treatment goals expected by the patient, including pregnancy desire or wish to preserve the uterus independently of reproductive goals.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=18167
http://ddd.uab.cat/record/308097
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=18167
http://ddd.uab.cat/record/308097
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER SCIENCE INC
publisher.none.fl_str_mv ELSEVIER SCIENCE INC
dc.source.none.fl_str_mv FERTILITY AND STERILITY
ISSN: 00150282
ISSNe: 15565653
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,198674

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