You’ve just learned that uterine fibroid embolization (UFE) could shrink your fibroids and end years of heavy bleeding and pelvic pressure. It sounds almost too good to be true: a minimally invasive procedure, a tiny puncture instead of a long incision, and a return to normal life in a week or two. But you’re also worried. Will it hurt? What if something goes wrong? Those fears are normal. In this article, we’ll explore the real risks and complications of UFE—from common side effects to rare but serious events—so you can make an informed decision with confidence.
Understanding UFE Risks: Context and Reassurance
UFE involves guiding a thin catheter into your uterine arteries and injecting tiny particles to block blood flow to fibroids. Because it uses X‑ray guidance and embolic agents, there are risks. Stanford Health Care underscores that complications are rare and fall into several categories: angiography (issues related to the catheter and access site), infection, ischemic complications (post‑embolization issues), thromboembolic events, radiation injury, adverse drug reactions, and other rare events . Johns Hopkins Medicine and Northwestern Medicine list similar complications .
Despite these risks, it’s important to remember that UFE is generally safe. Stanford notes that the death rate after UFE is about 1 in 5,000–7,000 cases, compared with 1 in 1,000 for elective hysterectomy . Most complications are manageable and temporary. Knowing what to watch for helps you prepare—and prevents small issues from becoming big ones.
Common Short‑Term Side Effects: Pain, Fever and Fatigue
Post‑Embolization Syndrome
Almost every woman who undergoes UFE experiences some level of pelvic pain or cramping. Stanford explains that pelvic pain occurs in almost every patient, peaking within hours and usually resolving within a few days to a week . Johns Hopkins lists post‑embolization syndrome symptoms as pelvic pain, vaginal discharge, nausea, vomiting, low‑grade fever and fatigue; these may last two to seven days . Northwestern echoes that pelvic pain and cramping, nausea, vomiting, fever and fatigue usually appear within hours to days and subside in about a week .
Flu‑Like Symptoms
Up to one‑third of women develop a fever (101°F or lower) as part of post‑embolization syndrome . You might feel like you have the flu: achy, tired and nauseous. This is your body’s reaction to tissue damage and is typically short‑lived. Medication and rest can relieve symptoms .
Angiography Complications: Bleeding and Bruising at the Access Site
Because UFE is performed through the femoral or radial artery, minor bleeding or bruising at the puncture site is common. Stanford’s angiography complications page reports that minor access site bleeding, bruising or small hematomas occur in less than 3% of patients and usually require no therapy . Major bleeding requiring transfusion is extremely rare and has not been reported in UFE . There is a tiny risk of vascular damage or dissection, but only two cases requiring minor interventions have been reported . If you see swelling, redness or unusual pain at the puncture site, call your doctor.
Contrast dye is used during the angiogram, which can cause allergic reactions or kidney problems. Severe anaphylactic reactions occur in about 1 in 100,000 to 1 in 140,000 administrations, according to Stanford . People with existing kidney disease may be at risk of temporary or permanent kidney failure from contrast exposure . If you have kidney problems or a history of allergies to iodine or shellfish, discuss this with your doctor. Medication can help prevent allergic reactions.
Infection Risks: Uterine Infections and UTIs
Infection is a serious but uncommon complication. Stanford reports that uterine infection (endometritis) occurs in up to 1 in 200 women and usually results from contamination of a fibroid that’s breaking down . Symptoms include fever, escalating pain and foul‑smelling discharge . Such infections are treated with antibiotics and rarely with hysterectomy if the infection becomes severe . Fewer than one death in over 10,000 patients has been reported from sepsis . UTIs can occur because a urinary catheter is used during the procedure and are usually treated with antibiotics . Wound infection at the puncture site is theoretically possible but has not been reported . Good hygiene and prompt medical attention for fever help mitigate these risks.
Ischemic Complications: Tissue Death, Sloughing and Premature Menopause
UFE intentionally blocks blood flow to fibroids. In rare cases, it may affect the uterine wall or other organs.
Pain and Fever
Ischemic pain is normal; it’s part of post‑embolization syndrome. The same section above covers pain and fever.
Fibroid Sloughing
About 5% of women pass fibroid fragments or entire fibroids weeks or months after UFE . This is most common with submucosal fibroids. It can cause intense crampy pain and a foul odor, but it often results in a reduced uterine size and improved symptoms . If you experience heavy bleeding, fever or foul‑smelling discharge during this process, see your doctor—there may be infection.
Non‑Target Embolization and Menopause
Non‑target embolization occurs when particles travel to nearby organs, typically the ovaries, affecting blood supply. Stanford estimates that up to 5% of women—usually those over 45—experience premature menopause or permanent loss of periods . About 5–10% temporarily lose their menses and experience hot flashes, but most resume menstruation within a few months . Johns Hopkins and Northwestern also warn that UFE can lead to infertility or premature menopause . If you’re near menopause anyway, UFE might push you into it sooner. Younger women can discuss hormone testing to assess ovarian reserve before deciding on UFE.
Thromboembolic Events: DVT and Pulmonary Embolism
Pelvic surgery and large uteruses can lead to sluggish blood flow in the pelvic veins. Stanford notes that deep vein thrombosis (DVT) and pulmonary embolism are potential complications . These events are rare but serious. Risk factors include obesity, prolonged immobilization and hormone therapy. Your doctor may prescribe blood thinners or compression stockings to minimize risk. Learn the signs—sudden leg swelling or chest pain—and seek immediate care if they occur.
Radiation Injury and Cancer Risks
UFE uses fluoroscopy (continuous X‑ray) to guide the catheter. Stanford emphasizes that radiation burns to the skin are theoretical and have not been reported . The ovaries receive a dose between 2 and 20 rads, which is not expected to affect fertility or cause cancer or genetic mutations . Modern machines use low‑dose protocols, and the benefits outweigh the minuscule radiation risks. If you’re concerned, ask your interventional radiologist about radiation safety measures.
Adverse Drug Reactions: Sedation and Pain Medicines
You’ll receive local anesthesia, sedatives and pain medications during UFE. Allergic reactions to these medicines can occur but are usually mild (dry mouth, urinary retention). In rare cases, severe reactions may occur . If you have a history of medication allergies or severe reactions, tell your medical team. They can adjust medication or provide prophylactic treatments.
Rare Complications: Death, Uterine Rupture and Sexual Dysfunction
Although extremely rare, the Stanford site reports that a handful of deaths have occurred from infection or pulmonary embolism, giving UFE a mortality rate of about 1 in 5,000–7,000 . This is still lower than the mortality rate for elective hysterectomy . There are isolated reports of uterine rupture during labor at a site where a fibroid died . Sexual dysfunction is uncommon; Stanford references one case of a woman losing sensation during orgasm, but most studies show no change or improved sexual satisfaction . These stories are alarming but not the norm. Sharing your fears with your doctor and having regular follow‑ups can ease anxiety.
Fertility and Pregnancy After UFE
Fertility after UFE remains a topic of debate. Johns Hopkins notes that pregnancy and fertility problems may occur . Some women successfully conceive after UFE, but there are reports of higher miscarriage rates and preterm delivery. If having children is a priority, myomectomy is usually recommended first . Our UFE Candidate Checklist dives deeper into fertility considerations.
When to Seek Medical Attention
During recovery, call your doctor immediately if you experience:
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Persistent fever (over 101.5°F) or chills that don’t respond to medication .
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Severe or worsening pain after the first week.
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Heavy vaginal bleeding or passing large clots .
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Foul‑smelling discharge or pus .
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Signs of DVT or pulmonary embolism (leg swelling, shortness of breath) .
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Swelling, redness or pain at the puncture site beyond mild bruising.
Don’t let fear keep you from getting help—most complications are manageable if treated promptly.
Hope, Healing and Natural Support
Reading a list of potential complications can feel overwhelming. But remember: millions of women have undergone UFE safely and found relief from fibroid symptoms. Complications are the exception, not the rule. Stanford notes that the overall risk of death after UFE is much lower than that of hysterectomy , and most side effects are temporary. The key is to choose an experienced interventional radiologist, discuss your medical history and follow post‑procedure instructions.
While you heal, support your body with holistic care. Research suggests a diet rich in green vegetables may help reduce fibroid risk. Our Fibroid Wellness Collection (herbal teas, nutrient‑dense supplements, anti‑inflammatory blends and castor‑oil packs) offers natural support to complement UFE recovery. These products promote liver detoxification, hormonal balance and inflammation reduction. They’re not cures, but they can ease cramping, boost energy and make you feel cared for.
Take Action: Your Next Steps
If you’re considering UFE, arm yourself with knowledge and not fear. Read our UFE Candidate Checklist to see if you qualify, our UFE Recovery Timeline for a week‑by‑week overview, and our comparative guide UFE vs. Myomectomy vs. Hysterectomy to understand all your options. Discuss any concerns with your healthcare team. And if you’re ready to support your healing naturally, visit our shop for safe, effective fibroid products. The journey to relief from fibroid pain and bloating is within reach so take the next step today.
