The Centre for Shared-decision Making asked the Norwegian Institute of Public Health to find and summarize key findings from systematic reviews about the comparative effectiveness of relevant treatment options for women with fibroids in the uterus. Fibroids affects eight in ten women. About a third experience troublesome symptoms such as pain, heavy menstrual bleeding, anaemia, and subfertility. The relevant treatment options are pharmacological treatment, embolization, myomectomy, and hysterectomy. The treatment options had to be compared to each other or to no treatment (placebo).
We found seven relevant systematic reviews from Cochrane that concluded:
- Hysteroscopic myomectomy probably increases pregnancy compared to no treatment, but this result is uncertain due to very wide confidence intervals.
- Tranexamacid probably reduced bleeding compared to placebo.
- Embolization probably reduced time getting back to activity compared to myomectomy and hysterectomy.
- Selective progesterone receptor modulators probably reduces symptoms compared to placebo.
- Non-steroidal anti-inflammatory drugs probably reduces bleeding compared to placebo.
- We have no evidence to determine the effectiveness of danazol or progestogens.