Uterine fibroids (benign growths in the muscular wall of the uterus) are very common among women worldwide, with incidence and prevalence steadily increasing over the past three decades, particularly in South Asia and low- and middle-income countries. The health burden is growing despite stable mortality rates, making it a key global women's health issue.
In this article, Dr. Gamal El-Din reviews the most prominent recent developments in the treatment of uterine fibroids, focusing on their impact on promoting the concept of personalized treatment, and their role in improving clinical outcomes and quality of life.
Uterine leiomyomas affect approximately one-third of women during their reproductive years, while studies indicate that most women may develop fibroids to varying degrees before the age of fifty, even if they remain asymptomatic.
Although they are benign tumors that only turn into malignant tumors in very rare cases, they are considered one of the most influential gynecological diseases affecting women’s health and quality of life, due to the heavy uterine bleeding, chronic pain, pressure on pelvic organs, and fertility and pregnancy problems they cause in some patients.
The effects of fibroids extend beyond health to encompass a woman's daily life. Chronic bleeding can lead to anemia and persistent fatigue, impacting work performance and social activities, while chronic pain can disrupt family and psychological well-being. For women planning a pregnancy, a fibroid diagnosis can be a source of anxiety and fear regarding its impact on fertility or the need for surgical intervention that could threaten the preservation of the uterus.
For many years, the treatment of fibroids was associated with hysterectomy, especially in women who had completed their reproductive years, and this procedure was considered the ultimate solution. However, scientific and technological advancements over the last two decades have radically changed this concept; preserving the uterus has become a primary goal in many cases, not only to maintain reproductive capacity, but also because of the functional and psychological importance of the uterus to women.
Recent research has contributed to a better understanding of the biological mechanisms of fibroid growth, enabling the development of more effective drug therapies, along with the emergence of less invasive treatment techniques, such as uterine artery embolization, focused ultrasound therapy, laparoscopic and robotic surgeries, as well as thermal ablation techniques, which represent promising options for carefully selected patients.
In light of this development, the treatment decision no longer depends solely on the size or number of the tumor, but is based on a comprehensive assessment that takes into account the patient’s age, the severity of symptoms, her desire to have children, the location of the fibroids, and the general health condition, in line with the concept of Personalized Medicine, which places the woman’s needs and expectations at the heart of the treatment plan.
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