Magnetic resonance imaging–guided focused ultrasound surgery, cryomyolysis, and transcervical temporary occlusion of the uterine arteries are emerging, minimally invasive options for leiomyomas therapy.

The efficacy of ulipristal acetate in the medical management of myomas is discussed and new guidelines are proposed.

Fibroids are frequent benign clonal tumors, promoted by sex steroids. They reduce quality of life through bleeding and fertility. Current medical treatment option, including GnRH analogues and selective progesterone receptor modulators, are discussed.

Next-generation sequencing has broadened our understanding on the genetics of uterine leiomyomas and together with previous knowledge led to an emerging molecular classification of the tumors.

In this work, we offer an overview of the current knowledge about somatic stem cells in murine and human myometrium and their putative implication in human leiomyoma formation.

The cellular, genetic, and hormonal understanding of uterine fibroids is rapidly growing, but the therapeutic options remain similar. Are we really advancing the field?