Guideline No. 461: The Management of Uterine Fibroids

Innie Chen & George Vilos et al. · 2025-06-23

To provide clinicians with an understanding of the clinical significance of fibroids for individuals with uteruses and provide evidence-based guidance on currently available treatment options. This clinical practice guidelines seeks to improve the lives of individuals with uterine fibroids and fibroid-associated menstrual bleeding or pressure symptoms. Fertility considerations are not discussed in detail, as they are described in the SOGC's Clinical Practice Guideline on The Management of Uterine Fibroids in Women with Otherwise Unexpected Infertility guideline. This clinical practice guideline is intended to facilitate the decision-making process between patients and healthcare providers regarding the assessment and management of symptomatic uterine fibroids. A majority of fibroid patients are asymptomatic and require no intervention. For patients with abnormal uterine bleeding, iron deficiency anemia, or pelvic pain or pressure symptoms, selected treatment should take into consideration fibroid characteristics and be directed towards patient symptoms and fertility goals. The cost of therapy to the healthcare system for individuals with fibroids must be interpreted in the context of the economic burden, lost productivity, and adverse impacts on quality of life that can be associated with untreated disease. This clinical practice guideline is an update of the SOGC's Clinical Practice Guideline No. 318 on The Management of Uterine Leiomyomas. A national panel of patient partners were gathered to provide feedback and perspective on the recommendations and summary statements for this guideline. Patient partners were purposefully selected to ensure representation of Canadian geographic region, racial representation, and fibroid-related symptom and treatment received. The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations). Health care providers involved in the assessment and management of individuals with uterine fibroids. Uterine fibroids are very common and can cause uterine bleeding and pressure symptoms. There should be a low threshold for investigation of such symptoms, as a variety of treatment options are available. RECOMMENDATIONS.
Authors
Innie Chen, Sari Kives, Elizabeth Randle, Darrien Rattray, Ari Sanders, George Vilos