علاج أورام الرحم الليفية مع أعراض الثقل الحوضي أو الضغط

References

DOI: 10.1016/j.jogc.2025.102970

• Patients with fibroids and bulk symptoms may be offered gonadotropin-releasing hormone agonists or antagonists.
• Long term use of these agents may be limited by hypoestrogenic effects, though this may be mitigated by add-back hormone replacement therapy.
• The use of GnRH agonist therapy has generally been used as a pre-operative adjunct, with duration of treatment limited to 3–6 months to shrink fibroids, reduce anemia related to uterine bleeding, and reduce surgical blood loss.
• Presently, the GnRH antagonists available in Canada are elagolix and relugolix, and both have been found to be effective in the treatment of AUB associated with fibroids in randomized controlled trials.
• In general, fibroids may be expected to shrink by up to 50% of their initial volume within 3 months of therapy.
• Recent randomized controlled trials indicate that GnRH antagonists can be used for reducing menstrual bleeding in patients with fibroids, with decreased uterine volume, and improvement in quality of life in a dose-response manner.