The current place of medical therapy in uterine fibroid management.

Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Current management strategies mainly involve surgical interventions, but the choice of treatment is guided by patient's age and desire to preserve fertility or avoid "radical" surgery. Surgical and non-surgical approaches include hysterectomy myomectomy by hysteroscopy, myomectomy by laparotomy or laparoscopy, uterine artery embolization, and magnetic resonance-guided focused ultrasound surgery. The need for alternatives to surgical intervention is very real, especially for women seeking to preserve their fertility. There is growing evidence of the crucial role of progesterone pathways in the pathophysiology of uterine fibroids, and the efficacy of long-term intermittent use of selective progesterone receptor modulators such as ulipristal acetate was recently demonstrated by randomized controlled studies.