The majority of fibroids develop during reproductive years, although they can remain silent or regress after menopause due to reduced estrogen and progesterone activity. Epidemiological studies indicate a higher prevalence among women of African descent compared to other ethnic groups, with risk factors including family history, obesity, early menarche, and certain dietary influences. On ultrasound, fibroids appear as heterogeneous, hypoechoic masses, while magnetic resonance imaging provides detailed assessment of size, location, and effect on uterine cavity. Pilocytic or pedunculated fibroids may also be visualized by hysteroscopy, aiding in differential diagnosis of intramural versus submucosal lesions.
Treatment options range from conservative medical management to surgical intervention. Hormonal agents such as gonadotropin‑releasing hormone agonists, selective progesterone receptor modulators, and aromatase inhibitors can reduce fibroid volume and alleviate symptoms. Uterine artery embolization, high‑intensity focused ultrasound, and MRI‑guided brachytherapy offer minimally invasive alternatives but may carry risks such as post‑embolization syndrome. Myomectomy preserves fertility and is commonly chosen by women desiring future pregnancies, whereas hysterectomy provides definitive cure but eliminates the possibility of childbearing. Patient counseling emphasizes the balance between symptom severity, treatment goals, and potential side effects, highlighting that many fibroids remain asymptomatic and may not require intervention.