Trial of Mifepristone for Fibroids

Inclusion Criteria: * Gender: Female * Age: 18 - premenopausal * Have at least moderate symptoms of menorrhagia or pelvic pain/pressure * Have a total uterine volume greater than or equal to 160 cc by ultrasound measurement and at least one fibroid that is =\> 2.5cm in size * Have a score of equal to or greater than 39 on the Uterine Fibroid Symptom and Quality of Life scale * Declined standard treatment options for symptomatic fibroids * Agree to use a double-barrier method (condoms, diaphragms) or other effective non-hormonal methods of contraception (abstinence, sterilization) throughout participation in the study to prevent pregnancy and to report any exposure to pregnancy to the research staff immediately * Willing and able to give informed consent * Willing and able to comply with study requirements Exclusion Criteria: * Current or planned pregnancy during the study period * Menopausal, as indicated by follicle stimulating hormone (FSH) level of the reference laboratory * Currently breast-feeding * Untreated abnormal pap smear * Presence of conditions other than fibroids contributing to pain and/or bleeding * Hemoglobin \< 9.0 mg/dl * Presence of adnexal masses or tenderness indicating further evaluation or surgery * Grade III or IV hydronephrosis by ultrasound * Severe, active mental health disorder * Active substance abuse or dependence * Presence of any contraindication to mifepristone including: * Adrenal insufficiency by history * Sickle cell disease * Active liver disease (liver function tests greater than 1.5 times upper range of normal) * Severe, respiratory disease (P02 saturation\< 92%) * Renal disease (serum creatinine \> 1.5 mg/dl) * Blood clotting defect. (abnormal PT and PTT) * Thromboembolic disease (history of deep vein thrombosis or pulmonary embolus) * Current or recent (within the past 3 months) use of the following medications: * Oral or systemic corticosteroids * Hormones: estrogens, progestins, oral contraceptives * Danazol, anticoagulants * Herbal or botanical supplements with possible hormonal effects. * Use within the past six months of the gonadotropin releasing hormones (GnRH) analogs or Depo-Provera. * Current or planned use during the study of any of the following medications/or products: * ketoconazole, * itraconazole, * erythromycin, * grapefruit juice, * rifampin, * St John's Wort, * phenytoin, * phenobarbital, or * carbamazepine