In asymptomatic uterine fibroids, the recommended management is?

• A. Endometrial ablation
• B. Radiation therapy
• C. Chemotherapy
• D. Observation

Answer: (D)

Observation is appropriate for asymptomatic uterine fibroids because many fibroids do not cause symptoms and tend to remain stable, so treating them offers little benefit while exposing the patient to procedure-related risks. Endometrial ablation addresses heavy menstrual bleeding but does not remove fibroids and is not indicated when there are no symptoms from the fibroids. Radiation therapy and chemotherapy are used for malignant or aggressive conditions and are not appropriate for benign fibroids. If symptoms such as heavy bleeding, pelvic pressure, or infertility develop, management can be adjusted to medical therapies or surgical options based on the patient’s goals and the fibroids’ size and impact. Fibroids often shrink after menopause, which further supports a watchful waiting approach in those without symptoms.