Patient presents with complaints consistent with uterine fibroids, clinically diagnosed as uterine leiomyoma.  Symptoms include heavy menstrual bleeding (menorrhagia), pelvic pressure, and abdominal discomfort.  Patient reports prolonged menses lasting greater than seven days and requiring frequent pad changes.  Physical examination reveals an enlarged, irregular uterus palpable abdominally.  Pelvic ultrasound confirms the presence of multiple intramural leiomyomas, the largest measuring 5 cm in diameter.  Differential diagnoses considered include adenomyosis, endometrial polyps, and ovarian cysts.  Assessment points towards symptomatic uterine leiomyomata.  The patient's anemia, secondary to heavy menstrual bleeding, will be addressed with iron supplementation.  Management options including medical management with hormonal therapy, minimally invasive procedures such as uterine artery embolization (UAE) or myomectomy, and hysterectomy were discussed.  The patient elected to begin medical management with a gonadotropin-releasing hormone agonist (GnRH agonist) to reduce fibroid size and control bleeding.  Risks, benefits, and alternatives of all treatment options were thoroughly explained.  Patient education provided regarding uterine fibroid symptoms, treatment options, and potential complications.  Follow-up scheduled in six weeks to assess response to therapy and discuss further management as needed.  Current procedural terminology (CPT) and International Classification of Diseases (ICD) codes will be documented appropriately for billing and coding purposes.