Treatment advances for fibroids, menopause

Women with fibroids and endometriosis facing the possibility of hysterectomy may now choose less invasive treatment options to preserve fertility, according to Yale professor Aydin Arici, M.D., who will direct a scientific session exploring these alternatives at the American College of Obstetricians and Gynecologists (ACOG) Annual Clinical Meeting May 3-7 in New Orleans, Louisiana. Arici will chair the two-day postgraduate ACOG course “Current Topics in Reproductive Endocrinology for the Clinician.” He joins colleagues in the Yale Department of Obstetrics, Gynecology & Reproductive Sciences as they lead other ACOG courses on menopause, managing post-term pregnancy, and managing patients with bleeding disorders during pregnancy.

In his course, Arici will present treatment options for endometriosis and share novel conservative approaches for treating fibroids, the most common benign tumor seen in reproductive-age women and the leading cause of hysterectomy in the United States.

“Our goal is to educate general obstetricians on ways to tailor new treatment techniques to the needs of individual patients,” said Arici. “For women in their 30s and 40s, preserving reproductive potential while treating fibroids is often desired. In the past, ovarian function was suppressed by inducing sudden menopause to shrink fibroids. Novel medications that were unavailable a few years back are now able to do so without unpleasant side effects.”

Arici said that conservative treatment options include a medical approach using selective estrogen receptor modulators and selective progesterone receptor modulators, uterine artery embolization, MRI-focused high-energy ultrasound, and conservative surgery using abdominal myomectomy, hysterectomy to remove the fibroids, but preserve the reproductive capacity of the uterus.

Yale Ob/Gyn reproductive endocrinologist Lubna Pal’s ACOG course will explore the biological, psychosocial and behavioral consequences of women’s transition into menopause and the postmenopausal years. One of her goals is to help doctors understand the predictors of menopause, and the treatment needs of women who have undergone hysterectomies or oophorectomies.

Errol Norwitz, M.D., will lead an interactive session on managing post-term or overdue pregnancies. He and his colleague will address issues such as the risks and benefits of routine induction of labor at 41 weeks gestation.

Source: Yale University