Purpose: We are conducting an 8-year follow up study to explore the natural history of noncancerous uterine conditions, identify predictors of use of and satisfaction with hysterectomy and alternatives, and assess the intermediate-term outcomes of these treatments. We conducted a cross-sectional analysis of the 1493 sociodemographically diverse participants who were seeking care for noncancerous uterine conditions who had not undergone hysterectomy. Methods: Participants were grouped by symptoms and completed a face-to-face interview during which they were asked about their symptoms and symptom impact, attitudes toward hysterectomy and alternatives, health-related quality of life, sexual functioning, and satisfaction with Western and complementary treatments. Preference for current health and 6 hypothetical outcomes of hysterectomy, uterus-preserving surgery, and medical treatment was measured using the time tradeoff (TTO) metric, and treatment preferences were assess using probability and symptom duration tradeoffs. Logistic regression was used to identify determinants of treatment satisfaction and willingness to consider hysterectomy. Results: Most (82.7%) participants reported lack of symptom resolution, half (49.7%) felt that their pelvic problems were interfering with their ability to have and enjoy sex, and few (17.0%) were satisfied with their health. Mean SF-12 physical (43 to 49) and mental (41 to 44) component summary scores were substantially lower than population norms. Mean current health TTO scores ranged from .78 to .88. Satisfaction with western medicines ranged from 31.3% (progestin IUD) to 58.2% (opiates); for uterine-preserving surgery they ranged from 20.0% (dilation and curettage) to 51.0% (myomectomy). 27.7 % of the women who used acupuncture were satisfied. Participants with lower educational attainment, greater symptom resolution, and less interference of pelvic problems with sex were more likely to be satisfied with their prior treatments. Women who desired future pregnancy were significantly more likely to prefer fertility-preserving treatments, while older and less educated women were more likely to prefer hysterectomy (p values ranged from <.001 to .045). Conclusion: Noncancerous uterine conditions are associated with serious decrements in health-related quality of life and sexual functioning and low rates of treatment satisfaction. Preferences regarding treatment options vary widely; tools to help women choose between treatment alternatives should be implemented into clinical care.