Uterine fibroid embolization (UFE) is an effective treatment for uterine fibroids. Still, there is the question…can UFE cause early menopause? The answer to this common question from women dealing with fibroids is a resounding “it depends.” For the most part, the risk increases with age just as everything else does. Premature menopause occurs more often with women over the age of 45.1
How UFE Works
Before diving into the issue at hand, it is important to explain how UFE works. During a UFE procedure, an interventional radiologist makes an incision in the skin of the wrist or the groin to insert a catheter. Using real-time imaging, the catheter is then guided through the arteries in that area to those that are feeding fibroids with blood. At that point, the radiologist embolizes the uterine arteries cutting off blood flow to the fibroids. Once this occurs, the symptoms subside and there are no more issues. UFE is considered safe and has a cure rate of almost 90 percent.2
Early Menopause Following UFE
Technically speaking, menopause is considered early when it takes place before the age of 40. There are factors that often impact the ability to go into early menopause following UFE. Because of this, it may be better to say premature menopause.
A very rare complication called non-target or inadvertent embolization may trigger menopause too soon. This happens if the blood vessels carrying blood to the ovaries are compromised during the procedure blocking off their supply. The Journal of Vascular and Interventional Radiology stated in an article that “non-target embolization of the ovarian blood vessels at the time of UFE is believed to be one cause of premature ovarian failure.”1
Experienced interventional radiologists can identify the interconnections of uterine and ovarian vessels to safely and effectively perform the UFE procedure without any complications.
The Fibroid Registry is a national data registry formed to assess the outcome of UFE to compare it to other fibroid treatments. The Registry’s data shows that following UFE most patients resume normal periods. In fact, the information states that one year following treatment, only 7% of women cease having a menstruation cycle due to ovarian failure.3 An interesting connection is that out of this group of patients, 86% are over 45 years old.3
Another common denominator for women over the age of 45 that experience menopause following UFE is that they are more apt to have higher levels of follicle-stimulating hormone (FSH). Increased FSH levels typically indicate declining ovaries which is a precursor to menopause.1 It is important to note that this outcome is also seen after uterine surgeries like hysterectomies indicating influences other than UFE.1
For the most part, the risk of early menopause following UFE is minimal since it is more likely to happen with women over 45 years old. Several long-term studies found no evidence for fibroid embolization advancing the timing of menopause in women before the age of 45 years. Menopause in women over 45 is not considered premature, so UFE doesn’t cause premature menopause.
At VivaEve we are committed to providing high-quality, personalized care for each and every patient we see. We will partner with you to determine the best way to treat your problematic fibroids or adenomyosis.
- Kaump, G. & Spies, J. (2013). The impact of uterine artery embolization on ovarian function. J Vasc Interv Radiol, Apr; 24(4): 459-467.
- McLucas, B., Voorhees Iii, W. D., & Elliott, S. (2015). Fertility after uterine artery embolization: a review. Minimally Invasive Therapy & Allied Technologies, 2: 1-7.
- Spies, J., Myers, E., Worthington-Kirsch, R., et al. (2005). The FIBROID Registry: symptom and quality-of-life status 1 year after therapy. Obstet Gynecol, Dec; 106(6): 1309-1318.
- Razavi, M., Wolanske, K., Hwang, G. et al. (2002). Angiographic classification of ovarian artery-to-uterine artery anastomoses: initial observations in uterine fibroid embolization. Radiology, Sep; 224(3): 707-712.