Medical Management Of Fibroid Uterus Ppt and Fibroids: What to Know

September 13, 2025

Medical Management Of Fibroid Uterus Ppt and Fibroids: What to Know

If you’re searching for “Medical Management of Fibroid Uterus PPT,” you’re likely preparing a presentation—or looking for a clear, structured overview—on how to treat uterine fibroids without surgery. This guide explains what fibroids are, who benefits most from medical therapy, the medications with the strongest evidence, and how to compare options. You’ll also find a ready-to-use slide outline to jumpstart a presentation, plus links to trusted resources from NIH, FDA, and leading medical organizations.

What are uterine fibroids?

Uterine fibroids (leiomyomas) are benign smooth muscle tumors of the uterus. They are common—most women develop them during their reproductive years. Many fibroids cause no symptoms, but some lead to heavy menstrual bleeding, pelvic pressure, urinary frequency, constipation, pain with sex, anemia, and, less commonly, fertility or pregnancy complications. Diagnosis is typically made with pelvic exam and imaging (most often ultrasound; MRI for complex cases).

When does medical management make sense?

Medical therapy is often preferred when you want to avoid or delay surgery, control heavy bleeding, improve quality of life, or stabilize symptoms before a procedure. It is especially helpful if:

Heavy menstrual bleeding is the main problem.
Fibroids are small to moderate in size and not severely distorting the uterine cavity.
You are nearing menopause (when fibroids often regress).
You want to preserve fertility (some options are compatible with future pregnancy, though not all can be used while trying to conceive).

Medical therapy may be less effective for very large fibroids or when bulk/pressure symptoms dominate; in those cases, procedural options may be needed.

Evidence-based medical options

1) Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs (e.g., ibuprofen, naproxen) can reduce menstrual cramps but have limited impact on heavy bleeding due to fibroids. They are available over the counter and can be combined with other therapies. Avoid if you have certain kidney, gastrointestinal, or bleeding conditions.

2) Tranexamic acid

Tranexamic acid (brand: Lysteda) is an FDA-approved, nonhormonal option for heavy menstrual bleeding. It is taken only on days of heavy flow and can reduce bleeding substantially. It does not shrink fibroids or provide contraception. It’s not appropriate if you have active or history of certain blood clots; discuss risks and drug interactions with your clinician.

3) Combined hormonal contraceptives

Combination birth control pills, patches, or rings help regulate cycles and decrease bleeding and cramps. They generally do not shrink fibroids but can markedly improve bleeding-related anemia and quality of life. Not suitable for everyone (e.g., smokers over 35, some migraine or clotting histories).

4) Progestin-only methods and the levonorgestrel intrauterine device (LNG-IUD)

Progestin-only pills, injections (e.g., depot medroxyprogesterone), and especially the 52 mg levonorgestrel-releasing intrauterine device can significantly reduce menstrual blood loss and anemia. The LNG-IUD is highly effective for heavy bleeding; expulsion risk can be higher with large or cavity-distorting fibroids. These methods provide contraception; discuss fertility goals with your clinician.

5) Gonadotropin-releasing hormone (GnRH) agonists

GnRH agonists (e.g., leuprolide) create a temporary, reversible low-estrogen state. They can reduce bleeding and shrink fibroids, often used short-term to correct anemia or before surgery. Side effects include hot flashes, mood changes, and bone density loss; “add-back” low-dose estrogen/progestin can mitigate these effects. Duration is typically limited.

6) Oral GnRH antagonists with add-back therapy

Newer oral regimens—elagolix/estradiol/norethindrone (brand: Oriahnn) and relugolix/estradiol/norethindrone (brand: Myfembree)—are FDA-approved for heavy menstrual bleeding due to fibroids in premenopausal women. They can substantially reduce bleeding and may shrink fibroids. Add-back therapy protects bone density and reduces vasomotor symptoms. These combinations are generally limited to up to 24 months due to bone health considerations. They are not contraceptives; effective contraception is recommended during use. Important considerations include blood pressure, clotting risk, liver function, and medication interactions.

7) Other options (less commonly used)

Aromatase inhibitors: Sometimes used off-label in select cases; evidence is limited.
Selective progesterone receptor modulators: Ulipristal acetate for fibroids is not FDA-approved in the U.S. due to rare but serious liver injury concerns; use is restricted in some regions.
Danazol: Largely avoided because of androgenic side effects.

8) Treating anemia

Iron supplementation (oral or, if needed, intravenous) can correct iron-deficiency anemia from heavy bleeding. Addressing anemia improves fatigue, exercise tolerance, and overall well-being while other therapies take effect.

Comparing options and setting expectations

Speed: Tranexamic acid and hormonal contraceptives often improve bleeding within 1–3 cycles; GnRH agonists/antagonists can work faster, especially for severe bleeding.
Bleeding reduction: Highest with LNG-IUD and GnRH-based therapies; moderate with combined hormonal methods and tranexamic acid.
Shrinking fibroids: Most likely with GnRH agonists or antagonists; limited shrinkage with other medical options.
Contraception: Provided by hormonal contraceptives and LNG-IUD; not by tranexamic acid or GnRH antagonists (additional contraception recommended).
Duration: Some therapies are suitable long term (LNG-IUD, combined hormonal methods); others have time limits (GnRH agonists/antagonists) due to bone health.

Safety, side effects, and monitoring

All treatments have potential risks. Your clinician may check blood pressure, clotting risk, liver function, and bone health depending on the regimen. Watch for new or worsening headaches, severe pelvic pain, very rapid abdominal growth, bleeding between periods, or symptoms of anemia (fatigue, shortness of breath). Seek urgent care for severe pain, fainting, or signs of blood clots (sudden leg swelling, chest pain, shortness of breath).

Fertility and pregnancy considerations

Many medical treatments are not used while trying to conceive or during pregnancy. If future fertility is a priority, discuss options that control symptoms now without compromising later plans (e.g., LNG-IUD can be removed when you’re ready to try; GnRH-based therapies are temporary). For women with recurrent pregnancy loss or infertility related to cavity-distorting fibroids, surgical options such as myomectomy may be recommended.

When to consider procedures instead

If medical therapy fails or if fibroids cause significant bulk symptoms, your clinician may discuss uterine artery embolization, myomectomy, radiofrequency ablation, MRI-guided focused ultrasound, or hysterectomy. The “best” choice depends on your symptoms, fibroid size and location, health profile, and reproductive goals.

PPT at-a-glance: Slide deck outline you can use

Title slide: Medical Management of Fibroid Uterus—What Clinicians and Patients Should Know
Epidemiology and pathophysiology
Symptoms, evaluation, and imaging
When medical therapy is appropriate (goals, patient selection)
First-line options: NSAIDs, tranexamic acid, combined hormonal contraceptives, LNG-IUD
Advanced options: GnRH agonists and oral GnRH antagonists with add-back
Special considerations: anemia management, fertility and pregnancy, perimenopause
Safety, contraindications, monitoring
Comparative effectiveness and duration
When to transition to procedures
Case studies and shared decision-making
Key takeaways and resources (NIH, FDA, ACOG)

Key takeaways

Medical therapy can safely and effectively control bleeding and improve quality of life for many people with fibroids.
The best regimen balances bleeding control, side effects, fertility goals, and how long you need treatment.
Work with your clinician to tailor therapy and monitor for side effects. Seek urgent care for severe symptoms.

Trusted resources and references

NIH MedlinePlus: Uterine Fibroids — https://medlineplus.gov/uterinefibroids.html
NICHD (NIH): Uterine Fibroids — https://www.nichd.nih.gov/health/topics/uterine
U.S. FDA: Approval of Myfembree for heavy menstrual bleeding associated with fibroids — FDA announcement
U.S. FDA: Approval of Oriahnn for heavy menstrual bleeding due to fibroids — FDA announcement
ACOG: Uterine Fibroids (Patient FAQ) — https://www.acog.org/womens-health/faqs/uterine-fibroids

This article is for educational purposes and does not replace personalized medical advice. Discuss your situation and treatment options with a qualified healthcare professional.