Prevalence, morbidity, and current medical management of uterine leiomyomas

Background: Uterine leiomyoma is the most common pelvic tumor in women, but the actual prevalence is unknown. Objectives: To review the literature on the prevalence of uterine leiomyoma, presenting symptoms, and medical management. Search strategy: On April 1-30,2014, a PubMed search for studies reported in English was conducted using the terms uterine leiomyoma, prevalence, and symptoms. Another search was performed using the terms uterine leiomyoma and treatment. Selection criteria: All trial types other than internet-only studies were included. Animal studies were excluded from the prevalence/symptom review, but included in the medical management review. Data collection and analysis: Prevalence rates were recorded on the basis of imaging modality, cohort studied, ethnic origin, and age. Main results: Studies involving asymptomatic women revealed a trend in prevalence similar to that in symptomatic women, and showed that leiomyomas are more common in this cohort than previously recognized. Affected patients can present with many complaints, but no single symptom has been shown to be specific for this tumor. Various medical therapies are reviewed, summarizing efficacy and toxicity. Conclusions: Further research needs to be conducted on the prevalence in asymptomatic women. Current and future medical management options provide promising results in symptom reduction. Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.