Patient-Centered Care and Uterine Fibroids
Semin Reprod Med 2017; 35: 560-564 DOI: 10.1055/s-0037-1607267Uterine leiomyomas are the most prevalent tumors in reproductive-aged women and are a major public health concern in the United States. Commonly known as fibroids, these benign tumors continue to be the leading cause of hysterectomy and are responsible for as much as $34 million in costs annually in the United States. Despite the increasing numbers of gains that are being made in understanding the pathophysiology of these tumors, relatively little work has been done to advance understanding of care delivery with regard to these tumors, specifically the patient p...
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: Marsh, Erica E. Chibber, Shani Saad, Wael Tags: Review Article Source Type: research
New and Emerging Therapies for Uterine Fibroids
Semin Reprod Med 2017; 35: 549-559 DOI: 10.1055/s-0037-1606303The pain, bleeding, and anemia associated with uterine fibroids debilitate many women. In addition to limited efficacy, the side effects of the currently used medical therapies prevent long-term use and nearly all pregnancies. Thus, women hoping to achieve pregnancy have limited options and usually opt for myomectomy. Once completed childbearing, many patients proceed with hysterectomy despite its risks and costs. Thus, there is a clear need for a new medical treatment for fibroids that is safe and effective. To this end, researchers have investigated several ne...
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: Fritton, Kate Borahay, Mostafa A. Tags: Review Article Source Type: research
Minimally Invasive Approaches to the Surgical Management of Fibroids
Semin Reprod Med 2017; 35: 533-548 DOI: 10.1055/s-0037-1606304Uterine fibroids, as the most common benign neoplasm of the female reproductive tract, can significantly impact a woman's quality of life through abnormal uterine bleeding, infertility, and bulk symptoms. When medical therapy for symptomatic fibroids fails, surgery is the recommended treatment. While a hysterectomy through laparotomy was historically the first-line surgical approach for fibroids, multiple minimally invasive and uterine-sparing techniques are now available. An evidence-based literature review of the following minimally invasive approaches is deta...
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: Wu, Harold Y. Wang, Karen C. Tags: Review Article Source Type: research
The Effect of Uterine Fibroids on Infertility: A Systematic Review
Semin Reprod Med 2017; 35: 523-532 DOI: 10.1055/s-0037-1607295Fibroids are present in up to 27% of patients seeking reproductive assistance, and can affect fertility through cavity distortion, alteration of endometrial receptivity, and sexual function. Surgical, noninvasive, and medical approaches have been developed to manage fibroids, but evidence-based data regarding their safety and efficacy for the treatment of infertility and the effects on pregnancy outcome are limited. Myomectomy, through minimally invasive techniques, is the most evidence-based approach to fibroids in women planning conception, and increases pregn...
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: Whynott, Rachel M. Vaught, Kamaria C. Cayton Segars, James H. Tags: Review Article Source Type: research
Current and Emerging Medical Treatments for Uterine Fibroids
Semin Reprod Med 2017; 35: 510-522 DOI: 10.1055/s-0037-1606302Uterine fibroids (leiomyomata) are common uterine neoplasms that are often associated with detrimental symptoms, such as heavy menstrual bleeding, dysmenorrhea, and pressure-related symptoms, which often lead to surgical intervention, including hysterectomy. Although our understanding of the pathophysiology of uterine fibroids, particularly their dependency on progesterone and the role of growth factors, has increased during the past two decades, the medical options currently approved by the United States Food and Drug Administration are limited and are only use...
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: Chwalisz, Kristof Taylor, Hugh Tags: Review Article Source Type: research
Activin A in Inflammation, Tissue Repair, and Fibrosis: Possible Role as Inflammatory and Fibrotic Mediator of Uterine Fibroid Development and Growth
Semin Reprod Med 2017; 35: 499-509 DOI: 10.1055/s-0037-1607265The growth factor activin A belongs to the transforming growth factor-β superfamily and was initially isolated as an inducer of follicle-stimulating hormone secretion. Activin A was later found to play roles in cell proliferation, differentiation, apoptosis, and metabolism. More recently, activin A has also been recognized as a novel player in mediating inflammation, immunity, wound repair, and fibrosis. Elevated levels of activin A during inflammation are responsible for the increased production of extracellular matrix in different pathological conditions, inc...
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: Protic, Olga Islam, Md Soriful Greco, Stefania Giannubilo, Stefano Raffaele Lamanna, Pasquale Petraglia, Felice Ciavattini, Andrea Castellucci, Mario Hinz, Boris Ciarmela, Pasquapina Tags: Review Article Source Type: research
Uterine Fibroids: Bridging Genomic Defects and Chronic Inflammation
Semin Reprod Med 2017; 35: 494-498 DOI: 10.1055/s-0037-1607240Uterine fibroids (UF; aka leiomyoma, myomas) are the most common benign tumors of female reproductive tract. They are highly prevalent, with 70 to 80% of women burdened by the end of their reproductive years. Fibroids are a leading cause of pelvic pain, abnormal vaginal bleeding, pelvic bulk symptoms, miscarriage, and infertility. They are the leading indication for hysterectomy, and costs exceed 34 billion dollars annually in the United States alone. Recently, somatic mutations in exons 1 and 2 of Med12 gene emerged as common UF driver mutations. Unfortunately,...
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: El Andaloussi, Abdeljabar Chaudhry, Zuni Al-Hendy, Ayman Ismail, Nahed Tags: Review Article Source Type: research
Mechanical Signaling and Extracellular Matrix in Uterine Fibroids
Semin Reprod Med 2017; 35: 487-493 DOI: 10.1055/s-0037-1607268Fibroids (uterine leiomyomas) are the most common benign tumors of the female reproductive tract. Steroid hormones, growth factors, and cytokines have long been implicated in fibroid growth; however, research suggests that changes in the extracellular matrix and mechanical signaling play a critical role in fibroid growth and differentiation. Studies have shown that growth of fibroids is related to the change in the volume and composition of extracellular matrix with increased deposition of abnormal collagen, glycoproteins, laminins, fibronectins, and an increase...
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: Rafique, Saima Segars, James H. Leppert, Phyllis C. Tags: Review Article Source Type: research
Origin of Uterine Fibroids: Conversion of Myometrial Stem Cells to Tumor-Initiating Cells
Semin Reprod Med 2017; 35: 481-486 DOI: 10.1055/s-0037-1607205Uterine fibroids (UFs) are the most frequent gynecologic tumors, affecting 70 to 80% of women over their lifetime, Although these tumors are benign, they can cause significant morbidity and may require invasive treatments such as myomectomy and hysterectomy in premenopausal women at a cost of up to $34 billion per year. Many risk factors for these tumors have been identified, including environmental exposures to endocrine-disrupting chemicals such as genistein and diethylstilbestrol (and other environmental agents) resulting in hyper-responsiveness to hormone in...
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: Elkafas, Hoda Qiwei, Yang Al-Hendy, Ayman Tags: Review Article Source Type: research
Uterine Fibroids: Burden and Unmet Medical Need
Semin Reprod Med 2017; 35: 473-480 DOI: 10.1055/s-0037-1607264Uterine fibroids affect a wide cross-section of the population, with prevalence, symptom severity, and overall disease burden generally higher among black women, likely due to both genetic and environmental factors. Potential symptoms of uterine fibroids include painful and excessive uterine bleeding, interference with everyday life and self-image, and impaired fertility. Because of the high estimated prevalence and costs associated with treatments, the direct and indirect costs of uterine fibroids are substantial for both the health care system and the individu...
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: Al-Hendy, Ayman Myers, Evan Robert Stewart, Elizabeth Tags: Review Article Source Type: research
Uterine Leiomyoma: New Perspectives on an Old Disease
Semin Reprod Med 2017; 35: 471-472 DOI: 10.1055/s-0037-1606569 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: Segars, James H. Al-Hendy, Ayman Tags: Preface Source Type: research
James H. Segars, MD and Ayman Al-Hendy, MD, PhD
Semin Reprod Med 2017; 35: 469-470 DOI: 10.1055/s-0037-1607998 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - November 3, 2017 Category: Reproduction Medicine Authors: Legro, Richard S. Tags: Introduction Source Type: research
Family Planning for Sexual Minority Women
Semin Reprod Med 2017; 35: 460-468 DOI: 10.1055/s-0037-1604456The family planning needs of sexual minority women (SMW) are an understudied but growing area of research. SMW have family planning needs, both similar to and distinct from their exclusively heterosexual peers. Specifically, SMW experience unintended pregnancies at higher rates than their exclusively heterosexual peers, but factors that increase this risk are not well understood. Contraception use is not uncommon among SMW, but lesbian women are less likely to use contraception than bisexual or exclusively heterosexual women. High rates of unintended pregnancy s...
Source: Seminars in Reproductive Medicine - October 26, 2017 Category: Reproduction Medicine Authors: Stoffel, Cynthia Carpenter, Emma Everett, Bethany Higgins, Jenny Haider, Sadia Tags: Review Article Source Type: research
Sexual Dysfunction in Lesbian Women: A Systematic Review of the Literature
Semin Reprod Med 2017; 35: 448-459 DOI: 10.1055/s-0037-1604455Over the past two decades, a growing body of literature has demonstrated the prevalence of sexual dysfunction in heterosexual women. Few, if any, studies have investigated sexual problems specifically in women who identify as lesbian. The aim of this article is to systematically review data on sexual dysfunction in lesbian women. We performed a systematic review of the literature searching MEDLINE via Ovid, EMBASE, PsycINFO, Cochrane Database of Controlled Trials, SCI-EXPANDED, SSCI, CPCI-S, CPCI-SSH, and Web of Science from inception through March 2017. We incl...
Source: Seminars in Reproductive Medicine - October 26, 2017 Category: Reproduction Medicine Authors: Sobecki-Rausch, Janelle Nicole Brown, Oluwateniola Gaupp, Christina Lewicky Tags: Review Article Source Type: research
Update on Gender-Affirming Treatment for the Transgender Woman
Semin Reprod Med 2017; 35: 442-447 DOI: 10.1055/s-0037-1604454Transgender women often transition with cross-sex hormone therapy and some opt to further affirm themselves with breast augmentation, facial feminization procedures, and/or vaginoplasty surgery. When considering medical and surgical transition for the transgender woman, careful preoperative evaluation and individual assessment is imperative and the World Professional Association for Transgender Health (WPATH) Standards of Care provide the framework from which health care providers and surgeons may assess eligibility for affirming treatments. Vaginoplasty for the...
Source: Seminars in Reproductive Medicine - October 26, 2017 Category: Reproduction Medicine Authors: Unger, Cecile A. Tags: Review Article Source Type: research
