Pathogenesis of uterine fibroids: current understanding and future directions

Fibroids are benign uterine tumors characterized by proliferation of uterine smooth muscle cells, embedded in an abundant extracellular matrix. Their prevalence is estimated to be more than 50% in women over the age of 45 years.Fibroids represent a considerable health burden. It is time to acquire a deeper mechanistic understanding of uterine fibroid-related etiology and pathogenesis, which may help pinpoint new strategies and an individualized approach. There is a need to gather prospective data and conduct studies to compare alternative approaches and assess long-term outcomes with respect to quality of life, recurrence of symptoms (bleeding, bulk symptoms), fertility, and even complications The goal of this review is to evaluate the widely accepted pathogenesis and identify risks factors and future directions for clinical and basic research into fibroids.