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  • Print publication year: 2014
  • Online publication date: June 2014

6 - Uterine fibroids and heavy menstrual bleeding

Summary

Uterine fibroids are the most common tumour of the female reproductive tract and occur in approximately 25% of women of reproductive age. Diagnosis of fibroids is made by imaging, either ultrasound or magnetic resonance imaging (MRI). Oestrogen is essential for fibroid growth. Gonadotrophin-releasing hormone (GnRH) agonists downregulate the pituitary with the subsequent decrease in estradiol levels leading to fibroid shrinkage. Standard treatment of fibroids consists of hysterectomy and myomectomy, the former being appropriate for those women who have completed their families and the latter for those who wish to retain their uterus. Uterine artery embolization (UAE) has been carried out for the treatment of uterine fibroids since 1995. UAE is successful in decreasing menstrual blood loss. The objective of UAE is to completely infarct all the fibroid tissue while preserving the uterus, ovaries and surrounding pelvic tissues.

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