Medical management of fibroids

Best Practice and Research: Clinical Obstetrics and Gynaecology

Volumn 22, Issue 4, 2008, Pages 655-676

  Sankaran, Srividhya ^a   Manyonda, Isaac T ^a  

^a ST GEORGE'S UNIVERSITY HOSPITALS NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

add back; asoprisinil; gonadotrophin releasing hormone analogues; hormones; leiomyoma; mifepristone; oestrogen; oestrogen receptor modulators; progesterone receptor modulators; progestogen; raloxifene; tamoxifen; uterine fibroids

Indexed keywords

ABARELIX; ANASTROZOLE; ANTIGESTAGEN; AROMATASE INHIBITOR; ASOPRISNIL; BUSERELIN; CABERGOLINE; CETRORELIX; DANAZOL; ESTRIOL; ESTROGEN; GESTRINONE; GONADORELIN ANTAGONIST; GONADORELIN DERIVATIVE; GOSERELIN; HEMOGLOBIN; HISTRELIN; LEUPRORELIN; LEVONORGESTREL; MEDROXYPROGESTERONE ACETATE; MIFEPRISTONE; NAFARELIN; PLACEBO; POLYLACTIC ACID; RALOXIFENE; SELECTIVE ESTROGEN RECEPTOR MODULATOR; TIBOLONE; TRANEXAMIC ACID; TRIPTORELIN;

ABDOMINAL HYSTERECTOMY; ACNE; ADD ON THERAPY; ADJUVANT THERAPY; BLEEDING; BLOATING; BONE DEMINERALIZATION; BONE DENSITY; BREAST TENDERNESS; CARDIOVASCULAR DISEASE; CLIMACTERIUM; CLINICAL EFFECTIVENESS; CLINICAL TRIAL; COGNITIVE DEFECT; COMBINATION CHEMOTHERAPY; CONTINUOUS INFUSION; COST EFFECTIVENESS ANALYSIS; DEPRESSION; DIZZINESS; DRUG ABSORPTION; DRUG BIOAVAILABILITY; DRUG COST; DRUG DOSE COMPARISON; DRUG DOSE REDUCTION; DRUG EFFICACY; DRUG ELIMINATION; DRUG ERUPTION; DRUG HALF LIFE; DRUG INDICATION; DRUG INDUCED HEADACHE; DRUG MECHANISM; DRUG MEGADOSE; DRUG POTENTIATION; DRUG RESPONSE; DRUG WITHDRAWAL; DRY SKIN; EDEMA; ESTROGEN BLOOD LEVEL; ESTROGEN SYNTHESIS; FEMALE; FOOT EDEMA; HEMOGLOBIN BLOOD LEVEL; HIGH INTENSITY FOCUSED ULTRASOUND; HIRSUTISM; HOARSENESS; HORMONAL REGULATION; HORMONAL THERAPY; HORMONE ACTION; HOT FLUSH; HUMAN; HYPERPLASIA; INCREASED APPETITE; INJECTION SITE REACTION; INSOMNIA; INTRAUTERINE CONTRACEPTIVE DEVICE; LEG CRAMP; LEG PAIN; LIBIDO; LIBIDO DISORDER; LOW DRUG DOSE; MENOPAUSAL SYNDROME; MENSTRUATION; MONOTHERAPY; MULTIPLE CYCLE TREATMENT; MUSCLE CRAMP; MUSCULOSKELETAL PAIN; MYOMECTOMY; NAUSEA; NERVOUSNESS; NONHUMAN; OSTEOLYSIS; PEROPERATIVE COMPLICATION; POSTMENOPAUSE; PREOPERATIVE CARE; PRIORITY JOURNAL; PROGESTERONE SYNTHESIS; REBOUND; REPEATED DRUG DOSE; REPRODUCTION; REVIEW; RISK REDUCTION; SEBORRHEA; SHORT COURSE THERAPY; SIDE EFFECT; SINGLE DRUG DOSE; SPOTTING; STOMACH PAIN; SURGICAL TECHNIQUE; SWEATING; THROMBOEMBOLISM; TUMOR GROWTH; ULTRASOUND THERAPY; UNSPECIFIED SIDE EFFECT; UTERINE ARTERY EMBOLIZATION; UTERUS MYOMA; VAGINAL DRYNESS; VASOMOTOR DISORDER; VENOUS THROMBOEMBOLISM; WEIGHT GAIN;

ANTINEOPLASTIC AGENTS, HORMONAL; DRUG THERAPY, COMBINATION; FEMALE; GONADOTROPIN-RELEASING HORMONE; HORMONE ANTAGONISTS; HUMANS; LEIOMYOMA; PROGESTERONE; UTERINE NEOPLASMS;

EID: 44949150110     PISSN: 15216934     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.bpobgyn.2008.03.001     Document Type: Review

References (108)

1. Wise L.A., Palmer J.R., Stewart E.A., et al. Age-specific incidence rates for self-reported uterine leiomyomata in the Black Women's Health Study. Obstet Gynecol 105 (2005) 563-568
2. Walker W.J., and Barton-Smith P. Long-term follow-up of uterine artery embolisation - an effective alternative in the treatment of fibroids. Br J Obstet Gynaecol 113 (2006) 464-468
3. Seinera P., Arisio R., Decko A., et al. Laparoscopic myomectomy: indications, surgical technique and complications. Hum Reprod 12 (1997) 1927-1930
4. Davies A., Hart R., and Magos A.L. The excision of uterine fibroids by vaginal myomectomy: a prospective study. Fertil Steril 71 (1999) 961-964
5. Spies J.B., Cooper J.M., Worthington-Kirsch R., et al. Outcome of uterine embolization and hysterectomy for leiomyomas: results of a multi-centre study. Am J Obstet Gynecol 191 (2004) 22-31
6. Hindley J., Gedroyc W.M.W., Regan L., et al. MRI guidance of focused ultrasound therapy of uterine fibroids: early results. AJR Am J Roentgenol 183 (2004) 1713-1719
7. Carpenter T.T., and Walker W.J. Pregnancy following uterine artery embolisation for symptomatic fibroids: a series of 26 completed pregnancies. Br J Obstet Gynaecol 112 (2005) 321-325
8. United States of America Food And Drug Administration. Center For Devices And Radiological Health Medical Devices Advisory Committee. Obstetrics And Gynecology Devices Panel, 68th Meeting, June 3, 2004. Available from:
9. National Institute for Clinical Excellence. Guide to the methods of technology appraisal. (Ref. N0515) (2004), National Institute for Clinical Excellence, London
10. Wilson E.A., Yang F., and Rees E.D. Estradiol and progesterone binding in uterine leiomyomata and in normal uterine tissue. Obstet Gynecol 55 (1980) 20-24
11. Tamaya T., Fujimoto J., and Okada H. Comparison of cellular levels of steroid receptors in uterine leiomyomas and myometrium. Acta Obstet Gynaecol Scand 64 (1985) 307-309
12. Knobil E. The neuroendocrine control of the menstrual cycle. Recent Prog Horm Res 36 (1980) 53
13. Jeffcoate J.L., Greenwood R.H., and Holland D.T. Blood and urine clearance of luteinizing hormone releasing hormone in man measured by radioimmunoassay. J Endocrinol 60 (1974) 305
14. Periti P., Mazzei T., and Mini E. Clinical pharmacokinetics of depot leuprorelin. Clin Pharmacokinet 41 (2002) 485-504
15. Bozzini N., Rodrigues C.J., Petti D.A., et al. Effects of treatment with gonadotropin releasing hormone agonist on the uterine leiomyomata structure. Acta Obstet Gynecol Scand 82 (2003) 330-334
16. Chegini N., and Kornberg L. Gonadotropin releasing hormone analogue therapy alters signal transduction pathways involving mitogen-activated protein and focal adhesion kinases in leiomyoma. J Soc Gynecol Investig 10 (2003) 21-26
17. Chegini N., Ma C., Tang X.M., et al. Effects of GnRH analogues, 'add-back' steroid therapy, antiestrogen and antiprogestins on leiomyoma and myometrial smooth muscle cell growth and transforming growth factor-beta expression. Mol Hum Reprod 12 (2002) 1071-1078
18. Chegini N., Verala J., Luo X., et al. Gene expression profile of leiomyoma and myometrium and the effect of gonadotropin releasing hormone analogue therapy. J Soc Gynecol Investig 10 (2003) 161-171
19. Deligdisch L., Hirschmann S., and Altchek S. Pathologic changes in gonadotropin releasing hormone agonist analogue treated uterine leiomyomata. Fertil Steril 67 (1997) 837-841
20. Reinsch R.C., Murphy A.A., Morales A.J., et al. The effects of RU 486 and leuprolide acetate on uterine artery blood flow in the fibroid uterus: a prospective, randomized study. Am J Obstet Gynecol 170 (1994) 1623-1628
21. Mesia A.F., Gahr D., Wild M., et al. Immunohistochemistry of vascular changes in leuprolide acetate-treated leiomyomas. Am J Obstet Gynecol 176 (1997) 1026-1029
22. Rutgers J.L., Spong C.Y., Sinow R., et al. Leuprolide acetate treatment and myoma arterial size. Obstet Gynecol 86 (1995) 386-388
23. Friedman A.J., Rein M.S., Harrison-Atlas D., et al. A randomized, placebo controlled, double-blind study evaluating leuprolide acetate depot treatment before myomectomy. Fertil Steril 52 (1989) 728-733
24. Friedman A.J., Hoffman D.I., Comite F., et al. Treatment of leiomyomata uteri with leuprolide acetate depot: a double-blind, placebo-controlled, multicenter study. Obstet Gynecol 77 (1991) 720-725
25. Schlaff W.D., Zerhouni E.A., Huth J.A., et al. A placebo-controlled trial of a depot gonadotropin-releasing hormone analogue (leuprolide) in the treatment of uterine leiomyomata. Obstet Gynecol 74 (1989) 856-862
26. Minaguchi H., wong J.M., and Snabes M.C. Clinical use of naferelin in the treatment of leiomyomas. A review of the literature. J Reprod Med 45 (2000) 481-489
27. Donnez J., Vivancos B.H., Kudela M., et al. A randomized, placebo-controlled, dose-ranging trial comparing fulvestrant with goserelin in premenopausal patients with uterine fibroids awaiting hysterectomy. Fertil Steril 79 (2003) 1380-1389
28. Leather A.T., Studd J.W., Watson N.R., et al. The prevention of bone loss in young women treated with GnRH analogues with 'add-back' estrogen therapy. Obstet Gynecol 81 (1993) 104-107
29. West C.P., Lumsden M.A., Lawson S., et al. Shrinkage of uterine fibroids during therapy with goserelin (Zoladex): a luteinizing hormone-releasing hormone agonist administered as a monthly subcutaneous depot. Fertil Steril 48 (1987) 45-51
30. Scialli A.R., and Jestila K.J. Sustained benefits of leuprolide acetate with or without subsequent medroxyprogesterone acetate in the nonsurgical management of leiomyomata uteri. Fertil Steril 64 (1995) 313-320
31. Palomba S., Affinito P., Tommaselli G.A., et al. A clinical trial of the effects of tibolone administered with gonadotropin-releasing hormone analogues for the treatment of uterine leiomyomata. Fertil Steril 70 (1998) 111-118
32. Gocmen A., Kara I.H., and Karaca M. The effect of add-back treatment with tibolone on patients with myoma uteri treated with triptorelin. Clin Exp Obstet Gynecol 29 (2002) 222-224
33. de Falco M., Staibano S., Pollio F., et al. Expression of proliferating cell nuclear antigen and Bcl-2 during a pseudomenopausal state induced by presurgical treatment of uterine leiomyomas with gonadotropin-releasing hormone analogues plus tibolone. Int J Gynecol Pathol 24 (2005) 286-291
34. Palomba S., Affinito P., Di Carlo C., et al. Long-term administration of tibolone plus gonadotropin-releasing hormone agonist for the treatment of uterine leiomyomas: effectiveness and effects on vasomotor symptoms, bone mass, and lipid profiles. Fertil Steril 72 (1999) 889-895
35. Palomba S., Russo T., Orio F., et al. Effectiveness of combined GnRH analogue plus raloxifene administration in the treatment of uterine leiomyomas: a prospective, randomized, single-blind, placebo-controlled clinical trial. Hum Reprod 17 (2002) 3213-3219
36. Palomba S., Orio F.J., Morelli M., et al. Raloxifene administration in women treated with gonadotropin releasing agonist for uterine leiomyomas: effects on bone metabolism. J Clin Endocrinol Metab 87 (2002) 4476-4481
37. Palomba S., Orio F.J., Russo T., et al. Gonadotropin-releasing hormone agonist with or without raloxifene: effects on cognition, mood and quality of life. Fertil Steril 82 (2004) 480-482
38. Palomba S., Orio Jr. F., Russo T., et al. Long-term effectiveness and safety of GnRH agonist plus raloxifene administration in women with uterine leiomyomas. Hum Reprod 19 (2004) 1308-1314
39. West C.P., Lumsden M.A., Hillier H., et al. Potential role for medroxyprogesterone acetate as an adjunct to goserelin (Zoladex) in the medical management of uterine fibroids. Hum Reprod 7 (1992) 328-332
40. Caird L.E., West C.P., Lumsden M.A., et al. Medroxyprogesterone acetate with Zoladex for long-term treatment of fibroids: effects on bone density and patient acceptability. Hum Reprod 12 (1997) 436-440
41. Carr B.R., Marshburn P.B., Weatherall P.T., et al. An evaluation of the effect of gonadotropin-releasing hormone analogs and medroxyprogesterone acetate on uterine leiomyomata volume by magnetic resonance imaging: a prospective randomized double blind placebo-controlled crossover trial. J Clin Endocrinol Metab 76 (1993) 1217-1223
42. Friedman A.J., Barbieri R.L., Doubilet P.M., et al. A randomized double-blind trial of a gonadotropin releasing hormone agonist (leuprolide) with or without medroxyprogesterone acetate in the treatment of leiomyomata uteri. Fertil Steril 49 (1988) 404-409
43. Nakayama H., Yano T., Sagara Y., et al. Estriol add-back therapy in the long-acting gonadotropin-releasing hormone agonist treatment of uterine leiomyomata. Gynecol Endocrinol 13 (1999) 382-389
44. Friedman A.J., Daly M., Juneau-Norcross M., et al. A prospective, randomized trial of gonadotropin releasing hormone agonist plus estrogen-progestin or progestin 'add-back' regimens for women with leiomyomata uteri. J Clin Endocrinol Metab 76 (1993) 1439-1445
45. Friedman A.J., Daly M., Juneau-Norcross M., et al. Longterm medical therapy for leiomyomata uteri: a prospective, randomized study of leuprolide acetate depot plus either oestrogen-progestin or progestin 'add-back' for 2 years. Hum Reprod 9 (1994) 1618-1625
46. Lethaby A., Vollenhoven B., and Sowter M. Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids. Cochrane Database Syst Rev 2 (2000) CD000547
47. Vercellini P., Maddalena S., Giorgi O.D., et al. Abdominal myomectomy for infertility: a comprehensive review. Hum Reprod 13 (1998) 873-879
48. Dubuisson J.B., Fauconnier A., Fourchotte V., et al. Laparoscopic myomectomy: predicting the risk of conversion to an open procedure. Hum Reprod 16 (2001) 1726-1731
49. ACOG Practice Bulletin. Surgical alternatives to hysterectomy in the management of leiomyomas. Int J Gynaecol Obstet 73 (2001) 285-294
50. Campo S., and Garcea N. Laparoscopic myomectomy in premenopausal women with and without preoperative treatment using gonadotrophin-releasing hormone analogues. Hum Reprod 14 (1999) 44-48
51. Seracchioli R., Colombo F.M., Bagnoli A., et al. Laparoscopic myomectomy for fibroids penetrating the uterine cavity: is it a safe procedure?. Br J Obstet Gynaecol 110 (2003) 236-240
52. Farquhar C.M., Brown P.M., and Furness S. Cost-effectiveness of preoperative gonadotrophin releasing analogues for women with uterine fibroids undergoing hysterectomy or myomectomy. Br J Obstet Gynaecol 109 (2002) 1273-1280
53. Kongnyuy E.J., van den Broek N., and Wiysonge C.S. A systematic review of randomized controlled trials to reduce hemorrhage during myomectomy for uterine fibroids. Int J Gynaecol Obstet 100 (2008) 4-9
54. Vercellini P., Trespidi L., Zaina B., et al. Gonadotropin-releasing hormone agonist treatment before abdominal myomectomy: a controlled trial. Fertil Steril 79 (2003) 1390-1395
55. Corbin A., Frederick J., Jones B., et al. Comparison of LHRH agonists and antagonists antifertility and therapeutic developments. In: Labrie F., Belanger A., and Dupont A. (Eds). LHRH and its analogs (1984), Elsevier, New York 95-122
56. Gordon K., Danforth D.R., Williams R.F., et al. Novel regimen of gonadotropin releasing (GnRH) antagonist plus pulsatile GnRH: controlled restoration of gonadotropin secretion and ovulation induction. Fertil Steril 54 (1990) 1140-1145
57. The Ganerelix Dose Finding Study Group. A double blind, randomized, dose finding study to assess the efficacy of the gonadotropin-releasing hormone antagonist gaverelix (Org 37462) to prevent premature luteinizing hormone surge in women undergoing ovarian stimulation with recombinant follicle stimulating hormone (Puregon). Hum Reprod 13 (1998) 3023-3031
58. Schultze-Mosgau A., Griesinger G., Altgassen C., et al. New developments in the use of peptide gonadotropin-releasing hormone antagonists versus agonists. Expert Opin Investig Drugs 14 (2005) 1085-1097
59. Kettel L.M., Murphy A.A., Morales A.J., et al. Rapid regression of uterine leiomyomas in response to daily administration of gonadotropin-releasing hormone antagonist. Fertil Steril 60 (1993) 642-646
60. Gonzalez-Barcena D., Alvarez R.B., Ochoa E.P., et al. Treatment of uterine leiomyomas with luteinizing hormone-releasing hormone antagonist Cetrorelix. Hum Reprod 12 (1997) 2028-2035
61. Flierman P.A., Oberyé J.J., van der Hulst V.P., et al. Rapid reduction of leiomyoma volume during treatment with the GnRH antagonist ganirelix. Br J Obstet Gynaecol 112 (2005) 638-642
62. Mitlak B.H., and Cohen F.J. In search of optimal long-term female hormone replacement: the potential of selective estrogen receptor modulators. Horm Res 48 (1997) 155-163
63. Dutertre M., and Smith C. Molecular mechanisms of selective estrogen receptor modulator (SERM) action. J Pharmacol Exp Ther 295 (2000) 431-437
64. Janine A., Carlos C., and Early J.E. Raloxifene: a selective estrogen receptor modulator. Am Fam Phys 60 (1990) 1131-1139
65. Palomba S., Sammartino A., Affinito P., et al. Effect of raloxifene treatment on uterine leiomyomas in postmenopausal women. Fertil Steril 76 (2001) 38-43
66. Palomba S., Orio F., Morelli M., et al. Raloxifene administration in premenopausal women with uterine leiomyomas: a pilot study. J Clin Endocrinol Metab 87 (2002) 3603-3608
67. Marsh E.E., and Bulun S.E. Steroid hormones and leiomyomas. Obstet Gynecol Clin North Am 33 (2006) 59-67
68. Jirecek S., Lee A., Pavo I., et al. Raloxifene prevents the growth of uterine leiomyomas in premenopausal women. Fertil Steril 81 (2004) 132-136
69. Ettingrr B., Black D.M., Mitlak B.H., et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene. JAMA 282 (1999) 637-645
70. Wu T., Chen X., and Xie L. Selective estrogen receptor modulators (SERMs) for uterine leiomyomas. Cochrane Database Syst Rev 4 (2007) CD005287
71. Smith I.E., and Dowsett M. Aromatase inhibitors in breast cancer. N Engl J Med 348 (2003) 2431-2442
72. Shozu M., Murakami K., and Inoue M. Aromatase and leiomyoma of the uterus. Semin Reprod Med 22 (2004) 51-60
73. Kaunitz A.M. Aromatase inhibitor therapy for uterine bleeding in a postmenopausal woman with leiomyomata. Menopause 14 (2007) 941-943
74. Shozu M., Murakami K., Segawa T., et al. Successful treatment of a symptomatic uterine leiomyoma in a perimenopausal woman with a nonsteroidal aromatase inhibitor. Fertil Steril 79 (2003) 628-631
75. The management of menorrhagia in secondary care. Evidence-based clinical guideline No. 5 (July 1999), Royal College of Obstetricians and Gynaecologists, London
76. Silverberg S.G., Haukkamaa M., Arko H., et al. Endometrial morphology during long term use of levonorgestrel releasing intra-uterine devices. Int J Gynaecol Pathol 5 (1986) 235-241
77. Irvine G.A., Campbell-Brown M.B., Lumsden M.A., et al. Randomised comparative trial of the levonorgestrel intrauterine system and norethisterone for treatmentof idiopathic menorrhagia. Br J Obstet Gynaecol 105 (1998) 592-598
78. Lahteenmaki P., Haukkamaa M., Puolakka J., et al. Open randomised study of use of levonorgestrel releasing intrauterine system as an alternative to hysterectomy. BMJ 316 (1998) 1122-1126
79. Hurskainen R., Teperi J., Rissanen P., et al. Quality of life and cost effectiveness of levonorgestrel releasing intrauterine system versus hysterectomy for treatment of menorrhagia: a randomised trial. Lancet 35 (2001) 273-277
80. Hurskainen R., Teperi J., Rissanen P., et al. Clinical outcomes and costs with the levonorgestrel-releasing intrauterine system or hysterectomy for treatment of menorrhagia. Randomised trial 5-year follow up. JAMA 291 (2004) 1456-1463
81. Lethaby A.E., Cooke I., and Rees M. Progesterone/progestagen releasing intrauterine system versus either placebo or any other medication for heavy menstrual bleeding. Cochrane Database Syst Rev 2 (2000) CD002126
82. Maruo T., Laoag-Fernandez J.B., Pakarinen P., et al. Effects of the levonorgestrel-releasing intrauterine system on proliferation and apoptosis in the endometrium. Hum Reprod 16 (2001) 2103-2108
83. Maruo T., Ohara N., Matsuo H., et al. Effects of levonorgestrel-releasing IUS ands progesterone receptor modulator PRM CDB-2914 on uterine leiomyomas. Contraception 75 (2007) S99-S103
84. National Collaborating Centre for Women's and Children's Health. Heavy menstrual bleeding: clinical guideline (2007), National Institute for Clinical Excellence, London
85. Manzo T., Matsuo H., Samoto T., et al. Effects of progesterone on uterine leiomyoma growth and apoptosis. Steroids 65 (2000) 585-592
86. De Leo V., Morgante G., La Marca A., et al. A benefit-risk assessment of medical treatment for uterine leiomyomas. Drug Saf 25 (2002) 759-779
87. Eisinger S.H., Meldrum S., Fiscella K., et al. Low-dose mifepristone for uterine leiomyomata. Obstet Gynecol 101 (2003) 243-250
88. Fiscella K., Eisinger S.H., and Meldrum S. Effect of mifepristone for symptomatic leiomyomata on quality of life and uterine size. Obstet Gynecol 108 (2006) 1381-1387
89. Brahma P.K., Martel K.M., and Christman G.M. Future directions in myoma research. Obstet Gynecol Clin North Am 33 (2006) 199-224
90. Chwalisz K., Elger W., Stickler T., et al. The effects of 1-month administration of asoprisnil (J867), a selective progesterone receptor modulator, in healthy premenopausal women. Hum Reprod 20 (2005) 1090-1099
91. Chwalisz K., Lamar Parker R., Williamson S., et al. Treatment of uterine leiomyomas with the novel selective progesterone receptor modulator (SPRM). J Soc Gynecol Investig 10 (2003) 636
92. Chwalisz K., Larsen L., McCrary K., et al. Effects of the novel selective progesterone receptor modulator (SPRM) asoprisinil on bleeding patterns in subjects with leiomyomata. J Soc Gynecol Investig 11 (2004) 728
93. Melli M.S., Farzadi L., and Madarek E.O. Comparison of the effect of gonadotropin-releasing hormone analog (Diphereline) and Cabergoline (Dostinex) treatment on uterine myoma regression. Saudi Med J 28 (2007) 445-450
94. La Marca A., Musacchio M.C., Morgante G., et al. Hemodynamic effect of danazol therapy in women with uterine leiomyomata. Fertil Steril 79 (2003) 1240-1242
95. Fedele L., Bianchi S., Marchini M., et al. Histological impact of medical therapy - clinical implications. Br J Obstet Gynaecol 102 Suppl 12 (1995) 8-11
96. De Leo V., la Marca A., and Morgante G. Short-term treatment of uterine fibromyomas with danazol. Gynecol Obstet Invest 47 (1999) 258-262
97. De Leo V., Morgante G., Lanzetta D., et al. Danazol administration after gonadotrophin-releasing hormone analogue reduces rebound of uterine myomas. Hum Reprod 12 (1997) 357-360
98. Telimaa S., Puolakka J., Ronnberg L., et al. Placebo-controlled comparison of danazol and medroxyprogesterone acetate in the treatment of endometriosis. Gynecol Endocrinol 1 (1987) 13-23
99. La Marca A., Giulini S., Vito G., et al. Gestrinone in the treatment of uterine leiomyomata: effects on uterine blood supply. Fertil Steril 82 (2004) 1694-1696
100. Coutinho E.M. Gestrinone in the treatment of myomas. Acta Obstet Gynecol Scand Suppl 150 (1989) 39-46
101. Coutinho E.M. Treatment of large fibroids with high doses of gestrinone. Gynecol Obstet Invest 30 (1990) 44-47
102. Coutinho E.M., and Gonçalves M.T. Long-term treatment of leiomyomas with gestrinone. Fertil Steril 51 (1989) 939-946
103. Young S.L., Al-Hendy A., and Copland J.A. Potential nonhormonal therapeutics for medical treatment of leiomyomas. Semin Reprod Med 22 (2004) 121-130
104. Lee B.S., Stewart E.A., Sahakian M., et al. Interferon-alpha is a potent inhibitor of basic fibroblast growth factor-stimulated cell proliferation in human uterine cells. Am J Reprod Immunol 40 (1998) 19-25
105. Mason H.R., Nowak R.A., Morton C.C., et al. Heparin inhibits the motility and proliferation of human myometrial and leiomyoma smooth muscle cells. Am J Pathol 162 (2003) 1895-1904
106. Nowak R.A. Novel therapeutic strategies for leiomyomas: targeting growth factors and their receptors. Environ Health Perspect 108 Suppl 5 (2000) 849-853
107. Loy C.J., Evelyn S., Lim F.K., et al. Growth dynamics of human leiomyoma cells and inhibitory effects of the peroxisome proliferator-activated receptor-gamma ligand, pioglitazone. Mol Hum Reprod 11 (2005) 561-566
108. Moghissi K.S. A clinician's guide to the use of gonadotropin-releasing hormone analogues in women. MedGenMed 2 1 (2000). http://www.medscape.com/viewarticle/408909 Available at: