What are the current first-line treatment options for symptomatic uterine fibroids in premenopausal women?

The current first-line treatment options for symptomatic uterine fibroids in premenopausal women include:

• Use of the levonorgestrel-releasing intrauterine system (LNG-IUS) as the first treatment for women with no identified pathology or fibroids less than 3 cm in diameter, which are not causing cavity distortion ¹.
• If LNG-IUS is declined or unsuitable, consider pharmacological options such as tranexamic acid, NSAIDs, combined hormonal contraception, or cyclical oral progestogens ¹.
• For women with fibroids of 3 cm or more in diameter, consider specialist treatments including uterine artery embolization, myomectomy, or surgical options like hysterectomy, especially if symptoms are severe or unresponsive to medication ¹.