The treatment of uterine myomas should be adapted individually to the patient's clinical condition.

Observation

Observation should be applied in the absence of: pain, abnormal genital bleeding, pressure symptoms and large myomas. This is especially true for peri-menopausal patients, when myomas may shrink. It should then be performed:

1. Gynaecological examination every 3-6 months to determine the size of the uterus
2. A thorough examination of the sacro-uterine ligaments to detect foci of endometriosis (often coexisting)
3. Regular blood count examination (iron deficiency anaemia - oral administration of iron preparations)
4. Medical US, especially with a TV transducer - allows visualisation of myometrial growth, possible ovarian enlargement (when clinical assessment is difficult), dilatation of the ureter and secondary hydronephrosis (compression of the myometrium). In doubtful cases, Medical Doppler US with vascularisation assessment can be performed.

Treatment

Treatment with gonadoliberin agonists can be undertaken: gonadotropin inhibition ® pseudomenopause; according to various regimens, usually for no longer than 6 months.

Used primarily as preparation for surgery - to reduce the size of the myomas and thus increase the safety of the surgery.

1. After use, a reduction of approx. 55 % in the size of myomas.
2. After the end of treatment, myomas tend to recur.
3. Not recommended in young women due to the possibility of osteoporosis.