Uterine
leiomyomas (also called myomata or
fibroids) are the most common gynecologic
tumors in the United States. The prevalence of
leiomyomas is at least 3 to 4 times higher among African American women than in white women. Pathologically, uterine
leiomyomas are benign
tumors that arise in any part of the uterus under the influence of local
growth factors and
sex hormones, such as
estrogen and
progesterone. These common
tumors cause significant morbidity for women and they are considered to be the most common indication for
hysterectomy in the world; they are also associated with a substantial economic impact on health care systems that amounts to approximately $2.2 billion/year in the United States alone. Uterine
myomas cause several reproductive problems such as heavy or abnormal
uterine bleeding, pelvic pressure,
infertility, and several obstetrical complications including
miscarriage and
preterm labor. Surgery has traditionally been the gold standard for the treatment of uterine
leiomyomas and has typically consisted of either
hysterectomy or
myomectomy. In recent years, a few clinical trials have evaluated the efficacy of orally administered medications for the management of
leiomyoma-related symptoms. In the present review, we will discuss these promising medical treatments in further detail.