Is Uterine Fibroid Embolization Safe? Fibroids: What to Know

Uterine fibroids are common, noncancerous growths that can cause heavy bleeding, pelvic pressure, pain, bloating, urinary frequency, and fertility challenges. If you’ve been told you have fibroids, you may be weighing procedural options beyond medication and surgery. Uterine Fibroid Embolization (UFE)—also called Uterine Artery Embolization (UAE)—is a minimally invasive procedure performed by an interventional radiologist to shrink fibroids and relieve symptoms. Here’s what to know about its safety, effectiveness, recovery, and how it compares with other treatments.

What are uterine fibroids?

Fibroids (leiomyomas) are benign tumors that develop in the uterus. They can vary widely in size and number. Many people have no symptoms, but fibroids can lead to heavy or prolonged periods, anemia, pelvic pain and pressure, constipation, urinary frequency, and painful intercourse. Fibroids are extremely common—by age 50, the majority of people with a uterus have them. Risk is influenced by age, family history, and race/ethnicity, with higher prevalence and symptom burden reported among Black women. Trusted overviews are available from the National Institutes of Health and MedlinePlus.

What is Uterine Fibroid Embolization (UFE)?

UFE is a catheter-based procedure that blocks the blood supply to fibroids, causing them to shrink. Under imaging guidance, a small catheter is inserted—typically through the wrist or groin—into the uterine arteries. Tiny particles (embolic agents) are delivered to reduce blood flow to fibroids while preserving the uterus. Most patients go home the same day or after an overnight stay. Pain and cramping are expected initially but usually improve within several days.

Is UFE safe?

For appropriately selected patients, UFE is considered safe and effective. Large professional organizations—including the American College of Obstetricians and Gynecologists (ACOG) and the Society of Interventional Radiology (SIR)—recognize UFE as a treatment option for symptomatic fibroids.

• Effectiveness: About 85–90% of patients experience significant relief from heavy bleeding and bulk-related symptoms after UFE, with sustained benefit for many years.
• Complication rates: Major complications are uncommon. Reported risks include infection, injury to the uterus or nearby tissues, blood clots, or the need for urgent surgery; these occur in a small minority of patients.
• Post-embolization syndrome: A temporary cluster of symptoms—pelvic pain, low-grade fever, fatigue, nausea—often occurs within the first week. It is typically managed with oral medications and hydration.
• Ovarian function: There is a small risk of changes in ovarian function, particularly in people aged 45 and older. Most premenopausal patients retain menstrual cycles, but your personal risk should be discussed with your clinician.
• Fibroid expulsion: Submucosal fibroids (those projecting into the uterine cavity) may pass through the cervix weeks to months after UFE, sometimes causing cramping or bleeding; rarely, a procedure is needed to remove expelled tissue.
• Radiation exposure: UFE uses X-ray guidance, but modern techniques keep radiation within safety limits comparable to other interventional procedures. Pregnancy must be ruled out beforehand.

As with any procedure, your individual risks depend on age, fibroid size and location, other medical conditions, and reproductive goals. A consultation with both a gynecologist and an interventional radiologist helps confirm whether UFE is appropriate for you.

Who is a good candidate—and who might not be?

UFE may be a good fit if you:

• Have symptomatic fibroids (e.g., heavy bleeding, pelvic pressure, bulk symptoms) and want to avoid or delay hysterectomy.
• Prefer a uterus-sparing option and are open to a minimally invasive procedure.
• Have multiple fibroids or fibroids that make surgical removal more complex.

UFE may not be ideal if you:

• Are pregnant or have an active pelvic infection (these are contraindications).
• Have a pedunculated subserosal fibroid on a thin stalk (embolization can be less predictable).
• Have suspected uterine cancer (rare, but requires different evaluation).
• Strongly prioritize future pregnancy—while pregnancies have occurred after UFE, data are less robust than for myomectomy, which is generally preferred when fertility is the primary goal.

How does UFE compare with other treatments?

• Medical therapy: Options include hormonal IUDs, tranexamic acid, combined hormonal contraceptives, and GnRH analogs/antagonists (short-term use) to reduce bleeding and shrink fibroids temporarily. These can control symptoms but often do not provide a definitive, long-term solution once medications are stopped.
• Myomectomy (surgical fibroid removal): Preserves the uterus and is often preferred for those seeking future pregnancy. Recovery is longer than UFE (especially with open surgery). Fibroids can recur over time, and another procedure may be needed.
• Hysterectomy (uterus removal): Definitive cure for fibroids with no risk of recurrence. It is major surgery with longer recovery and permanent loss of fertility.
• Endometrial ablation: Treats bleeding but not bulk symptoms and is not suitable for those desiring future pregnancy.

Reintervention rates after UFE (needing another procedure, such as repeat UFE, myomectomy, or hysterectomy) are reported in roughly 15–30% of patients within five years, similar to or slightly higher than some surgical approaches, depending on fibroid characteristics and patient age. Discuss your goals and the pros and cons of each option with your care team.

What to expect before, during, and after UFE

• Before: You’ll have imaging (often MRI or ultrasound) to map fibroids and rule out other causes of symptoms. Blood tests check for anemia and infection. Pregnancy is ruled out.
• During: Under local anesthesia and sedation, a small catheter is advanced to the uterine arteries using fluoroscopy (live X-rays). Embolic particles are delivered to block fibroid blood flow. The procedure typically takes 45–90 minutes.
• After: Cramping, fatigue, and low-grade fever are common for several days. Most patients return to routine activities within 7–10 days. Bleeding improvements often appear within 1–3 cycles; bulk symptoms may improve gradually over 3–6 months as fibroids shrink.

Safety tips and questions to ask your provider

• Is UFE appropriate for my fibroid size, number, and location?
• How will this procedure affect my fertility and ovarian function given my age?
• What are your complication rates, and how do you manage pain and post-embolization syndrome?
• How much radiation exposure is expected, and what steps are taken to minimize it?
• What symptoms should prompt me to call you or seek urgent care after the procedure?
• If UFE doesn’t control my symptoms, what are my next options?

Choose a center with board-certified interventional radiologists and close collaboration with gynecology. Most insurers cover UFE for symptomatic fibroids, but preauthorization is common—ask your clinic to help verify benefits.

Bottom line

Uterine Fibroid Embolization is a well-studied, minimally invasive option that can safely and effectively reduce heavy bleeding and pelvic pressure for many people with fibroids. It is not the best fit for everyone—especially those actively planning pregnancy—but for the right candidates, UFE offers durable relief with a short recovery. A balanced discussion with a gynecologist and an interventional radiologist can help you decide whether UFE aligns with your health goals.

Trusted sources and further reading

• MedlinePlus (NIH): Uterine Fibroids and Uterine Artery Embolization
• American College of Obstetricians and Gynecologists (ACOG): Uterine Artery Embolization FAQ and Uterine Fibroids
• Society of Interventional Radiology (SIR): Patient information on UFE
• NICHD (NIH): Fibroids overview
• NCBI/StatPearls: Uterine Fibroid Embolization

This article is for general education and is not a substitute for personal medical advice. Always consult your clinician for recommendations tailored to you.