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In both the USA and the European Medicines Agency region, selected gonadotropin\u2010releasing hormone (GnRH) antagonists have been approved for this indication. GnRH analogs are primarily indicated for the preoperative management of uterine fibroids, largely because of their unfavorable long\u2010term adverse effect profile. The previously approved therapy with ulipristal acetate had to undergo extensive restrictions because of safety concerns. Nevertheless, there are additional medications that may be used in clinical practice. These include combined oral contraceptives, oral progestins, the levonorgestrel\u2010releasing intrauterine system (LNG\u2010IUS), and tranexamic acid. Although not specifically approved for the treatment of fibroids, these agents can reduce the intensity of bleeding in cases of heavy menstrual bleeding and thereby improve symptoms and lead to an improved quality of life for the patients.<\/jats:p>","DOI":"10.1002\/ijgo.70497","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T09:38:40Z","timestamp":1757497120000},"page":"507-512","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Medical treatment of fibroids:\n                    <scp>FIGO<\/scp>\n                    best practice guidance"],"prefix":"10.1002","volume":"171","author":[{"given":"Ivonne","family":"Diaz","sequence":"first","affiliation":[{"name":"Fertility Unit PMA Sanitas University and Nueva Granada Military University Medical School  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Ann","family":"Lumsden","sequence":"additional","affiliation":[{"name":"School of Medicine University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8929-3105","authenticated-orcid":false,"given":"Magdalena","family":"Zeppernick","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Justus Liebig University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2174\/1381612826666210101152820"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13102"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2018.61.2.192"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.5603\/AIT.a2015.0011"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2217\/WHE.13.28"},{"issue":"4","key":"e_1_2_10_7_1","article-title":"Antifibrinolytics for heavy menstrual bleeding","volume":"4","author":"Bryant\u2010Smith AC","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000725"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-023-02549-z"},{"key":"e_1_2_10_10_1","volume-title":"StatPearls","author":"Chauncey JM","year":"2023"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3237"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.07.031"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2011.614028"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.steroids.2014.05.002"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.07.044"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.304.4219"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000238343.62063.22"},{"issue":"11","key":"e_1_2_10_18_1","article-title":"Progestogens or progestogen\u2010releasing intrauterine systems for uterine fibroids (other than preoperative medical therapy)","volume":"11","author":"Sangkomkamhang US","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-128X(00)00124-0"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-2797-9"},{"issue":"9","key":"e_1_2_10_21_1","article-title":"The impact of hormonal replacement treatment in postmenopausal women with uterine fibroids: a state\u2010of\u2010the\u2010art review of the literature","volume":"55","author":"Moro E","year":"2019","journal-title":"Medicina (Kaunas)"},{"key":"e_1_2_10_22_1","volume-title":"Contraception for Women Aged over 40\u2009Years. 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