ABSTRACT
Uterine leiomyomata are the most common tumors occurring in pre-and perimenopausal women.1,2 African-American women develop uterine leiomyomata at a higher frequency and at earlier ages than Caucasian women.3 leiomy omata are symptomatic in approximately one-third of women and they are responsible for significant morbidity in pre-and peri menopausal women. The clinical presentation of these tumors is associated with the following: heavy uterine bleeding; local mass effect, result ing in pressure upon adjacent organs; pain, or problems related to pregnancy, including infer tility and repetitive pregnancy loss.2 Abnormal uterine bleeding is by far the most common com plaint in these women and represents the major indication for surgical intervention. As a con sequence, uterine leiomyomata rank as the major indication for hysterectomy worldwide. In the United States, approximately 600,000
hysterectomies are performed annually, with the diagnosis of leiomyomata accounting for approximately one-third of these.4"7
Despite the high prevalence of uterine leiomy omata and their enormous health-related eco nomic impact, there has been little basic research and almost no focused drug development aimed at suppressing bleeding and reducing pressurerelated symptoms in women with uterine leiomyomata. According to the recent systematic review of the literature on the surgical and nonsurgical management of uterine leiomyomata, the available evidence on the management of uterine leiomyomata is of remarkably poor quality.8
