A senior obstetrician-gynaecologist in Qatar discussed the latest treatment options for uterine fibroids at the latest instalment of Grand Rounds organised by Weill Cornell Medicine - Qatar.
Dr David Barlow, director, women’s services at Hamad Medical Corporation, and chair of the Department of Obstetrics and Gynaecology at The Women’s Hospital, discussed the most commonly used surgical procedures for removal of uterine fibroids and new drug therapies that have been developed to manage the condition without the need for surgery.
Uterine fibroids are very common non-cancerous tumours that form on the wall of the uterus. It is believed as many as 70 to 80% of women will have uterine fibroids at some point in their lives, though most will not notice them because they often cause no symptoms. For those women who do experience symptoms, these can include heavy or painful periods and pain in the abdomen or lower back. In rare cases, uterine fibroids can affect pregnancy or cause infertility.
Dr Barlow said: “Finding effective treatments for uterine fibroids is important because they affect a large number of women and can be extremely painful and distressing, and can also negatively affect fertility, which is naturally very distressing. Fortunately, surgical procedures and new drug therapies have proven to be quite effective and there have been promising new developments recently.”
Uterine fibroids can range from pea-sized to the size of a melon. They are linked to the hormone estrogen and are most common during childbearing years when estrogen levels are highest.
Dr Barlow explained that the traditional treatment method was surgical removal of the fibroids, but this is an invasive procedure and there has been a need for an effective drug option that would shrink the fibroids and alleviate symptoms, allowing women to have children, potentially without having to have surgery.
For more than a decade there has been a short-term drug option that can be used as a prelude to surgery. These are the gonadotropin releasing hormone agonists. However very recently a drug option has become available that has the potential to be used over an extended period of time providing the desired fibroid shrinkage and alleviated symptoms. This drug option acts on the progesterone receptor and is known as a selective progesterone receptor modulator. This option is likely to especially useful for women with fibroids seeking pregnancy and for older women with fibroids who would like to avoid hysterectomy.