Gynäkologische Endokrinologie

, Volume 13, Issue 4, pp 226–231 | Cite as

Medikamentöse Myomtherapie

  • Michael K. Bohlmann
  • A. Hornemann
  • N. Sänger
  • A. Hackethal
  • K. von Horn
  • P.S. Wilkens
  • F. Hoellen
Leitthema
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Zusammenfassung

Hintergrund

Uterusmyome treten bei vielen Frauen im reproduktiven Alter auf.

Therapie

Die Behandlung symptomatischer Befunde umfasst neben operativen und radiologisch-interventionellen Methoden auch medikamentöse Ansätze. Letztere werden insbesondere zur Blutungskontrolle, bei Kontraindikationen der genannten Alternativen und zur Verbesserung der präoperativen Ausgangslage eingesetzt. Da das Myomwachstum durch Hormone beeinflusst wird, fanden über längere Zeit besonders Gonadotropin-Releasing-Hormon(GnRH)-Agonisten Anwendung, während zur Blutungskontrolle traditionell kombinierte orale Kontrazeptiva, Gestagene oder hormonfreisetzende Intrauterinsysteme im Sinne eines „off label use“ verschrieben wurden. Im Jahr 2012 hat die Europäische Arzneimittel-Agentur Ulipristalacetat aus der Wirkstoffklasse der selektiven Progesteronrezeptormodulatoren für die Anwendung bei Frauen mit symptomatischen Uterusmyomen zugelassen.

Zielsetzung des Beitrags

Diese Übersichtsarbeit beleuchtet Vor- und Nachteile der einzelnen medikamentösen Wirkstoffe.

Schlüsselwörter

Uterusmyome Kombinierte orale Kontrazeptiva Gonadotropin-Releasing-Hormon-Agonisten Ulipristalacetat Selektive Progesteronrezeptormodulatoren 

Drug therapy of uterine fibroids

Abstract

Background

Uterine fibroids affect a large number of women in the reproductive years.

Treatment

Therapeutic options of symptomatic fibroids include surgical, radiological interventional and conservative approaches with drugs. Medicinal approaches are mainly used to control bleeding, in cases of contraindications to surgical or radiological treatment and preoperatively to improve the initial situation. Due to the hormone-responsive growth of uterine fibroids, gonadotropin-releasing hormone (GnRH) analogs played a major role in the treatment, whereas combined oral contraceptives, progestogens and intrauterine systems that release hormones were administered in an off-label setting. In 2012 ulipristal acetate, a selective progesterone receptor modulator, was approved by the European Medicines Agency to be used in women with symptomatic fibroids.

Aim

This review article illustrates the advantages and disadvantages of the individual drug treatment options.

Keywords

Fibroids, uterine Contraceptives, oral, combined Gonadotropin-releasing hormone, agonists Ulipristal acetate Selective progesterone receptor modulators 
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Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

F. Hoellen und P.S. Wilkens geben an, dass kein Interessenkonflikt besteht. K. Bohlmann erhielt Vortragshonorare von CSL Behring, Gedeon Richter und LEO Pharma. A. Hackethal ist als Berater für Olympus, Johnson & Johnson und Nordic Pharma tätig und erhielt Honorare für Vorträge sowie für die Durchführung von Live-Operationen. N. Sänger erhielt Vortragshonorare von Gedeon Richter. A. Hornemann ist als Berater für Olympus und Aesculap tätig und erhielt Vortragshonorare von Gedeon Richter.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Michael K. Bohlmann
    • 1
  • A. Hornemann
    • 1
  • N. Sänger
    • 2
  • A. Hackethal
    • 3
  • K. von Horn
    • 4
  • P.S. Wilkens
    • 5
  • F. Hoellen
    • 5
  1. 1.FrauenklinikUniversitätsmedizin MannheimMannheimDeutschland
  2. 2.Abteilung für Gynäkologische Endokrinologie und Reproduktionsmedizin, Klinik für Frauenheilkunde und GeburtshilfeUniversitätsklinikum FrankfurtFrankfurtDeutschland
  3. 3.Tagesklinik AltonaHamburgDeutschland
  4. 4.Universitäres Kinderwunschzentrum LübeckUniversitätsklinikum Schleswig-Holstein, Campus LübeckLübeckDeutschland
  5. 5.Klinik für Frauenheilkunde und GeburtshilfeUniversitätsklinikum Schleswig-Holstein, Campus LübeckLübeckDeutschland

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