Uterine Fibroids and Evidence-Based Medicine — Not an Oxymoron

The 2011 report from the Agency for Healthcare Research and Quality on comparative management of uterine fibroids noted, “Despite the prevalence and possible complications of uterine fibroids, few published studies examining the effectiveness of treatment strategies exist.”1 Few therapies are approved by the Food and Drug Administration (FDA) for fibroids; leuprolide acetate, a gonadotropin-releasing hormone (GnRH) agonist, was approved in 1995 for preoperative treatment of fibroids, with the addition of iron. In the past decade, uterine-artery embolization and magnetic-resonance–guided focused ultrasound surgery have also been therapeutic options. Surgeries for fibroids, especially hysterectomy, still predominate, and fibroids remain the leading cause . . .