Many, if not most women with fibroids, do not realize they have them because they are asymptomatic. These may be small fibroids that don’t require treatment beyond regular observation to ensure they aren’t getting larger. Larger fibroids can cause a variety of symptoms for which you should seek treatment, such as:

• Excessive bleeding during periods or between periods
• Uterine pressure or pain
• Frequent urination or inability to urinate
• Chronic vaginal discharge
• Pain during intercourse
• Lower back pain
• Constipation
• Abdominal enlargement

Even if you’re healthy and not at higher-than-average risk from surgery, traditional surgeries such as hysterectomies are much harder on the body and can take weeks to recover from. In contrast, UFEs are usually performed in outpatient clinics and most patients can resume normal daily activities very quickly.

Hysterectomies are also typically done under general anesthesia, while UFEs are performed under local anesthesia. And of course, a hysterectomy involves removing the uterus, while under UFE the uterus remains intact.

Due to the risk to the fetus, treatment options for uterine fibroids during pregnancy are limited, and UFE is not recommended. However, in contrast to guidance from years past, new research is showing that women who have had UFE in the past can have successful pregnancies with vaginal deliveries, although there does remain some risk. UFE also allows you to preserve your uterus, so if you wish to become pregnant sometime after undergoing UFE, it is possible to do so.

Hormone replacement therapy (HRT) is an alternative fibroid treatment to UFE. Injections or nasal sprays are given that inhibit the production of estrogen in the ovaries, thereby slowing the growth of or shrinking fibroids. However, new data linking HRT to heart attacks and strokes is causing many doctors to reconsider using them. Those that do use them limit them to a maximum of six months due their ability to cause menopause symptoms such as hot flashes, night sweats, and bone loss.

Many women are medically unable to take hormones, as they may be unsafe for patients with…

• History or risk of heart attack, stroke, or blood clots
• Unexplained vaginal bleeding
• Past or current breast cancer
• Fibrocystic breast disease
• Liver disease
• Gallbladder disease
• Endometrial cancer

Because UFE is minimally invasive, it can be a better fit for women with certain pre-existing conditions that can make traditional gynecological surgery for uterine fibroids inadvisable. For example, surgical site infection, venous thromboembolism, and wound complications are more prevalent in obese women than in normal-weight women.

Patients with high body mass index are also at higher risk of blood clots during surgery, as well as low oxygen levels and difficult recovery after general anesthesia.

Bleeding or clotting disorders such as anemia and hemophilia can also make surgery more complicated than you wish to risk.

UFE utilizes X-ray technology to guide the catheter into the left and right uterine arteries. This process uses an iodinated contrast dye to provide the “map” for the catheter. Patients who have chronic kidney disease or a known allergy to iodine-containing contrast will want to consider a different treatment option than UFE.