Uterine fibroid embolization, or UFE, shrinks fibroids by cutting off their blood supply. An interventional radiologist guides a thin catheter through a pinhole in the wrist or groin to the arteries that feed the uterus, then releases tiny particles that lodge in the small vessels supplying the fibroids. Deprived of blood, the fibroids soften and shrink over the following months. The uterus itself keeps its normal supply from other vessels and stays in place.
For women whose fibroids cause heavy periods, pelvic pressure or a bladder that never feels empty, UFE offers a way to treat the problem without a hysterectomy and without the recovery of open surgery. It is done under sedation, takes about an hour, and most women go home the same day and return to ordinary activity within days rather than weeks.
At NYMD Center, UFE is a team procedure. Your gynecologist makes the diagnosis, orders the MRI, decides with you whether embolization is the right treatment, and manages your recovery. Dr. Yosef Golowa, our fellowship-trained interventional radiologist, performs the embolization. This page is an overview; our fibroid center site at 1fibroid.com goes into far more depth.
Who it affects and the symptoms that bring people in
Fibroids are non-cancerous growths of the muscle wall of the uterus. They are very common, most often found in women in their thirties and forties, and many cause no trouble at all. The ones that do tend to announce themselves in one of three ways.
The first is bleeding: periods that are heavy enough to soak through protection, last longer than a week, pass clots, or leave you anemic and exhausted. The second is pressure: a sense of fullness or a visible bulge in the lower abdomen, pain during sex, or low back ache. The third is urinary. A fibroid pressing on the bladder causes urinary frequency, urgency, and waking at night to urinate, which is why some women arrive after first seeing one of our urologists for what looked like a bladder problem.
Fibroids can also affect fertility, depending on where they sit, and some women come in for that reason.
How we evaluate it at NYMD Center
Evaluation starts with one of our gynecologists, such as Dr. Tamara Guichard, Dr. Julia Raber, Dr. Hina Ahmad or Dr. Deirdre Johnson Gundy. The visit covers your bleeding pattern, pain, urinary symptoms, and whether you are planning a pregnancy, because that answer shapes the recommendation.
A pelvic exam and in-office ultrasound confirm fibroids and give a first look at their size and number. Blood work through our on-site lab checks for anemia and, when the picture calls for it, thyroid and hormone levels that can also cause heavy bleeding.
Every woman being considered for UFE has a pelvic MRI before a decision is made. MRI maps each fibroid, shows how it is supplied with blood, and identifies the ones that will not respond well to embolization. It also rules out adenomyosis and other conditions that mimic fibroids. Where the bleeding pattern raises any concern about the uterine lining, your gynecologist may recommend an endometrial biopsy or hysteroscopy first.
Treatment options
Watchful waiting and medication
Fibroids that are not causing significant symptoms do not need treatment. For bleeding, hormonal options such as a progestin IUD, birth control pills or tranexamic acid during periods can reduce flow considerably and cost nothing in recovery. They do not shrink the fibroids, and pressure symptoms usually persist. Medications that suppress estrogen can shrink fibroids temporarily but are limited by side effects and are generally used short term, for example before surgery.
Uterine fibroid embolization
UFE treats all the fibroids in the uterus at once, addresses bleeding, pressure and urinary symptoms together, keeps the uterus, and avoids general anesthesia and incisions. Recovery is measured in days. The trade-offs are honest ones: the fibroids shrink rather than disappear, the first few days involve real cramping, a small number of women do not get enough relief and go on to surgery, and it is not the first choice for a woman actively planning pregnancy. Because nothing is removed, every surgical option remains available afterward.
Myomectomy
Surgical removal of the fibroids while preserving the uterus. It can be done hysteroscopically for fibroids inside the cavity, laparoscopically, or through an open incision for large or numerous fibroids. It is the usual recommendation for women who want to become pregnant, and it removes the tissue rather than shrinking it. Recovery ranges from days for hysteroscopic removal to several weeks for open surgery, and fibroids can grow back.
Hysterectomy
Removal of the uterus is definitive; fibroids cannot recur. It is major surgery under general anesthesia with a recovery of several weeks, ends fertility, and carries the risks of any abdominal operation. For some women it is the right answer, particularly when other conditions coexist, and our gynecologists perform it when it is. We do not recommend it as a first step for fibroids alone when a less invasive treatment is likely to work.
What to expect at your visit
Your first appointment is with a gynecologist, at either the Manhattan or Forest Hills office. Bring a record of your recent cycles if you have one, a list of medications, and any prior imaging reports. If UFE is a reasonable option, the MRI is scheduled, and once Dr. Golowa has reviewed it you meet with him to go over the procedure, the plan for your arteries, and the recovery.
On the procedure day you arrive at our Manhattan surgery center having fasted as instructed. A sedative is given through an IV, the puncture site is numbed, and the embolization takes about an hour. You rest in recovery for a few hours while cramping is controlled, and go home the same day with someone to accompany you. Expect cramping, fatigue and possibly low-grade fever for a few days, with medication to manage it. Most women are back at a desk within a week and fully active within two. Your gynecologist sees you in the weeks that follow and tracks your bleeding and symptoms over the next several months as the fibroids shrink.
When to seek care urgently
Call us the same day if bleeding soaks a pad an hour for several hours, if you feel faint or short of breath, or if you have fever above 101°F, worsening pain after the first few days, or a foul-smelling discharge following the procedure. Sudden severe pelvic pain with fever at any time should be evaluated promptly.
Questions patients ask
Does UFE remove the fibroids?
No. It cuts off their blood supply so they soften and shrink over the following months, and the symptoms they cause ease as they do. The fibroids remain in the uterus as smaller, inactive tissue. For most women that is exactly the goal: relief from bleeding and pressure without an operation. If you specifically want a fibroid removed, for example a large one distorting the cavity in a woman planning pregnancy, your gynecologist will discuss myomectomy instead.
Will I keep my uterus?
Yes. That is the main reason women choose embolization over hysterectomy. The uterus and ovaries are untouched, and nothing is removed. Hysterectomy is definitive but is major surgery with a recovery measured in weeks; UFE treats the same symptoms with a recovery measured in days and leaves the option of surgery open if it is ever needed.
Can I get pregnant after UFE?
Pregnancies do occur after UFE, but it is not the first choice for a woman who is actively planning a pregnancy, because the effect on the uterine lining and blood supply is harder to predict than after a myomectomy. If future pregnancy matters to you, say so at the first visit. Your gynecologist will weigh that against the size, number and position of the fibroids before recommending a path.
How much pain is there afterward?
The first day or two bring cramping, sometimes strong, as the fibroids lose their blood supply. We manage it with medication given before you leave and a plan for home, and it fades over several days. Low-grade fever, fatigue and a light discharge for a week or two are common and expected. Most women are back to desk work within about a week.
Why do I need an MRI first?
Ultrasound tells us fibroids are present; MRI tells us how many, exactly where they sit, how large they are, and how they are supplied with blood. That determines whether embolization is likely to work and whether a different treatment would serve you better. It also rules out other causes of the symptoms. Dr. Golowa uses the same images to plan the procedure.
When will my bleeding improve?
Heavy bleeding often improves within the first one or two cycles after the procedure, because the fibroids lose their blood supply immediately. Pressure, urinary frequency and bloating improve more gradually as the fibroids shrink, usually over three to six months. Your gynecologist sees you during that window and repeats imaging if the response is slower than expected.
Make an appointment
Manhattan (212) 991-9991 · Forest Hills (718) 360-9550 · same-week visits, most major insurance accepted.