Uterine fibroids (leiomyomas) are the most common benign smooth-muscle tumours in women of reproductive age and represent a significant source of morbidity—ranging from heavy menstrual bleeding and pelvic pain to infertility and adverse pregnancy outcomes. Contemporary conceptions of fibroids emphasise their heterogeneity, molecular underpinnings, hormonal and environmental drivers, and evolving therapeutic options that aim to preserve fertility and minimise invasiveness. This review synthesises current literature on fibroid aetiology, pathophysiology, clinical manifestations, diagnostics, and modern and emerging management strategies with a view toward “modern conceptions” of the disease. The review draws on ten or more recent scientific studies and reviews, identifies gaps in our knowledge, and highlights future directions, including integration with artificial-intelligence methods for diagnosis and treatment planning.

uterine fibroids, leiomyoma, pathophysiology, diagnosis, management, fertility, minimally invasive therapy

Marsh E.E., Wegienka G., Williams D.R. “Uterine Fibroids.” JAMA 2020;324(3):298-299. DOI: [see article].

Yang Q., Ciebiera M., Bariani M.V., et al. “Comprehensive Review of Uterine Fibroids: Developmental Origin, Pathogenesis, and Treatment.” Endocrine Reviews. 2021 Nov;43(4):678-719. DOI:10.1210/endrev/bnab039.

Alali O.M., Churnosov M.I. “The etiopathogenesis of uterine leiomyomas: A review.” Gynecology. 2023;25(1):22-30. DOI:10.26442/20795696.2023.1.201827.

Navarro A., Bariani M.V., Yang Q., Al-Hendy A. “Understanding the Impact of Uterine Fibroids on Human Endometrium Function.” Frontiers in Cell and Developmental Biology. 2021;9:633180. DOI:10.3389/fcell.2021.633180.

Havryliuk Y., Setton R., Carlow J.J., Shaktman B.D. “Symptomatic Fibroid Management: Systematic Review of the Literature.” JSLS. 2017;21(3):e2017.00041.

Ahmad A., Kumar M., Bhoi N.R., et al. “Diagnosis and management of uterine fibroids: current trends and future strategies.” Journal of Basic and Clinical Physiology and Pharmacology. 2023;34(3).

Hartmann K.E., Fonnesbeck C., Surawicz T., et al. “Management of Uterine Fibroids: Comparative Effectiveness Review No. 195.” Agency for Healthcare Research and Quality (US). 2017 Dec.

Yelena Havryliuk et al. (same as ref 5) – note this provides a broad review of procedural options.

Decoding uterine (dys)function in fibroids through multimodal assessment of functional determinants: a systematic review and meta-analysis. Human Reproduction Open. (2022/23). 10. Afaq M., Zlotshewer B.A., Oliveros E., Bauman S.G., Vaidya A., Lakhter V., Forfia P., Sadek A.S., Hernandez E., Bashir R. “Uterine Fibroids and Their Association with Acute and Chronic Venous Thromboembolic Disease—An Expert Review of the Literature.” J Clin Med. 2025;14(12):4065.