Key facts

  • Hormone (FSH and AMH) changes suggesting reduced ovarian reserve are reported after uterine artery embolization (UAE, also called UFE), more often in patients 45 or older; one study estimated about a 15% chance of FSH rising into the perimenopausal range at that age1,2.
  • A randomized trial found hysterectomy affects ovarian reserve similarly to UAE, with no significant difference between the two groups2.
  • Fibroids often shrink with natural menopause. Treatment may still be discussed for symptoms3.
  • A fibroid that grows, or a new uterine mass, after menopause should be evaluated promptly because cancer must be ruled out.
  • Talk with your doctor before you decide. This information does not replace personal medical advice.

What the evidence says about UFE and menopause

Two studies measured FSH and AMH, hormones that reflect ovarian reserve, rather than diagnosing ovarian failure directly. In a study of UAE alone, FSH rose into the perimenopausal range only in patients aged 45-50, and the authors estimated about a 15% chance of this happening in patients 45 or older; the study found no difference between age groups in new menopausal symptoms1. In a randomized trial comparing UAE with hysterectomy, FSH rose above 40 IU/L by 24 months in 14 of 80 patients after UAE, compared with 17 of 73 after hysterectomy, a difference the authors did not find statistically significant; AMH changes also did not differ significantly between the two groups. The authors concluded that both UAE and hysterectomy affect ovarian reserve2.

Because both studies tracked hormone levels rather than a clinical diagnosis of ovarian failure, this page describes the outcome as hormone (FSH/AMH) changes suggesting reduced ovarian reserve, not ovarian insufficiency.

A quality improvement guideline for uterine artery embolization4 and a Cochrane systematic review of uterine artery embolization for symptomatic uterine fibroids (CD0050735) are among the sources for this page.

Why this matters: Hormone changes suggesting reduced ovarian reserve can change periods and hormone-related symptoms. Ask your own clinicians how the reported pattern at age 45 or older applies to you. For what to ask before any embolization, see questions to ask before UFE.

Questions to ask

  • How should I understand these hormone changes after UAE, and how would we know if they happened to me?
  • How does my age change the questions I should ask about UFE and ovarian function?
  • Do you want any ovarian-reserve testing before we decide?

Fibroids and natural menopause

Fibroids often shrink with natural menopause. That can matter when treatment is being discussed around the years of menopause, because a wait-and-watch approach and active treatment are both conversations a clinician can have with you. Read the what are fibroids guide for how fibroids are described.

Questions to ask

  • Where am I in the menopause transition, and how does that change the timing of a decision?
  • Would watching symptoms with follow-up be reasonable in my situation?
  • Which symptoms would make waiting less suitable for me?

Can you have UFE after menopause?

Treatment may still be discussed for symptoms after menopause. Whether UFE fits after menopause is a question for your own clinicians, who can review your symptoms and imaging. Other fibroid guides are collected in the fibroid article library, and the UFE recovery timeline describes what recovery can involve.

Red flag: A fibroid that grows, or a new uterine mass that appears, after menopause should be evaluated promptly because cancer must be ruled out. Women evaluated for a presumed fibroid should be assessed for malignancy risk, since leiomyosarcoma cannot be reliably diagnosed before surgery6.

Questions to ask

  • If I am past menopause, what would UFE offer me that other options do not?
  • Do I need new imaging or a gynecologic evaluation before that conversation?
  • Who should be in the conversation: my gynecologist and an interventional radiologist?
  • Has my fibroid grown, or is there a new mass, since menopause that needs prompt evaluation?

Questions to ask before you decide

Hormone changes suggesting reduced ovarian reserve are reported after UAE, more often in patients 45 or older, and a randomized trial found hysterectomy affects ovarian reserve similarly1,2. Fibroids often shrink with natural menopause. Treatment may still be discussed for symptoms3. Talk with your doctor before you decide.

Questions to ask your doctor

  • How do you weigh the reduced-ovarian-reserve pattern in patients 45 or older against my situation?
  • What follow-up would show whether UFE affected ovarian function?
  • For how the procedures differ aside from menopause, see UFE vs hysterectomy for questions to take to that specialist.

Common questions

Does UFE cause menopause?

Hormone (FSH and AMH) changes suggesting reduced ovarian reserve have been reported after uterine artery embolization (UAE, also called UFE), more often in patients 45 or older. A randomized trial found hysterectomy affects ovarian reserve similarly, with no significant difference between the two groups1,2. Talk with your doctor before you decide.

Does my age change the risk of early menopause after UFE?

Yes. One study found FSH rose into the perimenopausal range only in patients aged 45-50, and estimated about a 15% chance of this happening in patients 45 or older, with no difference between age groups in new menopausal symptoms1. Another study found FSH above 40 IU/L in 14 of 80 patients after UAE at 24 months, versus 17 of 73 after hysterectomy, a difference the authors did not find statistically significant2. Ask your doctor how age applies to you. Talk with your doctor before you decide.

Do fibroids shrink after menopause?

Fibroids often shrink with natural menopause. Talk with your doctor before you decide.

Can you have UFE after menopause?

Treatment may still be discussed for symptoms after menopause. Red flag: a fibroid that grows, or a new uterine mass that appears, after menopause should be evaluated promptly because cancer must be ruled out. Women evaluated for a presumed fibroid should be assessed for malignancy risk, since leiomyosarcoma cannot be reliably diagnosed before surgery6. Whether UFE fits after menopause is a question for your own clinicians, who can review your symptoms and imaging. Talk with your doctor before you decide.

Should I wait for menopause instead of having UFE?

Fibroids often shrink with natural menopause. Treatment may still be discussed for symptoms3. Whether waiting or having treatment is right for you depends on your symptoms and goals. Talk with your doctor before you decide.

Talk with your doctor before you decide. This information does not replace personal medical advice. Read the medical disclaimer.

Sources

  1. Ovarian function after uterine artery embolization, FSH study (PMID 11287529) ↩︎
  2. Ovarian reserve after UAE compared with hysterectomy, EMMY substudy (PMID 17582145) ↩︎
  3. Symptomatic uterine leiomyomas, 2021 guideline (PMID 34011888) ↩︎
  4. Uterine artery embolization quality improvement guideline (PMID 25442136) ↩︎
  5. Cochrane systematic review of uterine artery embolization (PMID 25541260) ↩︎
  6. ACOG Committee Opinion on uterine morcellation for presumed leiomyomas (PMID 30801477) ↩︎