Recent advances in medical treatment of uterine fibroids

Uterine fibroids (leiomyomas) are the most common benign gynecologic tumor. Common presentation includes abnormal uterine bleeding, pelvic pain, pressure symptoms, reduced fertility and obstetric complication. Steroids play a key role in the pathogenesis of UF by enhancing the expression of autocrine/paracrine growth factors, cytokines and chemokines, which results in the proliferation and deregulation of the extracellular matrix of leiomyoma cells. Generally, hysterectomy is the only definitive treatment available, however this intervention is oftentimes, not an optimal solution for women of child-bearing age as it eliminates the chance for future pregnancies. In recent years, several medical strategies have evolved in the treatment of uterine fibroids including e.g., hormonal agents e.g., GnRH analogs, Levonorgestrel intrauterine system, selective progesterone receptor modulators, selective estrogen receptor modulators, Aromatase inhibitor and other therapeutics such as All-trans retinoic acid, TGF-β receptor inhibitors, EGF receptor inhibitors, Catechol-O-methyl transferase inhibitor, Vit D, Green Tea Extracts, Halofuginone, Genistein and Curcumin.... Although surgery is the most effective treatment for uterine leiomyoma, other medical options have been investigated and show promising results. More research is needed to evaluate the short and long term efficacy of these novel approaches.