Alternatives to excisional therapy: a clinical review of our current options to conservatively manage symptomatic leiomyomas

Curr Opin Obstet Gynecol. 2018 Aug;30(4):279-286. doi: 10.1097/GCO.0000000000000470.


Purpose of review: This article provides a clinical review of the alternatives to traditional excisional surgical therapies for uterine leiomyomas, such as myomectomy or hysterectomy.

Recent findings: In this review, currently available hormonal medications will be briefly discussed. Then, nonhormonal medical therapy will be addressed with respect to mechanism of action, safety, and efficacy. Finally, the risk-benefit profile of nonexcisional procedures for management of leiomyomas will be addressed.

Summary: This provides an update on the information available for more conservative options for symptomatic leiomyoma management.

Publication types

  • Review

MeSH terms

  • Antifibrinolytic Agents / therapeutic use
  • Aromatase Inhibitors / therapeutic use
  • Female
  • Gonadotropin-Releasing Hormone / agonists
  • Gonadotropin-Releasing Hormone / antagonists & inhibitors
  • Humans
  • Leiomyoma / therapy*
  • Magnetic Resonance Imaging, Interventional
  • Norpregnadienes / therapeutic use
  • Radiofrequency Ablation
  • Receptors, Progesterone / drug effects
  • Tranexamic Acid / therapeutic use
  • Ultrasonic Therapy
  • Uterine Artery Embolization
  • Uterine Neoplasms / therapy*


  • Antifibrinolytic Agents
  • Aromatase Inhibitors
  • Norpregnadienes
  • Receptors, Progesterone
  • Gonadotropin-Releasing Hormone
  • Tranexamic Acid
  • ulipristal acetate