Medical Management of Uterine Fibroids
While surgery is often required to completely remove symptomatic fibroids, medical management offers nonsurgical options to help control symptoms and potentially shrink fibroids. Medications used in uterine fibroids treatment drugs aim to alter the hormonal environment that supports fibroid growth.
Gonadotropin-Releasing Hormone (GnRH) Agonists
One class of drugs that has been used off-label for Uterine Fibroids Treatment Drugs is GnRH agonists. These synthetic hormones bind to GnRH receptors in the pituitary gland and block the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The subsequent estrogen deprivation experienced mimics a temporary menopausal state which can cause fibroids to shrink by 60-80% in size within 3-6 months for most women. Common side effects include menopause-like symptoms such as hot flashes, night sweats, and vaginal dryness. Benefits are temporary as fibroids will regrow once treatment ends and bone density loss is a concern with long-term use.
Selective Progesterone Receptor Modulators (SPRMs)
Another option for medical management is SPRMs which block the effects of progesterone on fibroid tissue. The primary drug in this class, Ulipristal acetate (UPA), was FDA approved in 2020 and shown to significantly reduce heavy menstrual bleeding and fibroid symptoms for up to 6 months in studies. Side effects are generally mild but can include headache, nausea, and abdominal pain. UPA offers a non-surgical alternative for women seeking to delay fibroid surgery or fertility treatments. Continued clinical research aims to expand SPRM options.
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