Fibroid Treatment Guide
Fibroid Treatment in Manhattan
Fibroids are common, and you have more choices than many women are told. This guide walks through every fibroid treatment available in Manhattan, from watchful waiting and medication to uterine fibroid embolization (UFE), myomectomy and hysterectomy, with how each works, recovery, fertility and what the research shows, so you can decide with your gynecologist. Dr. David Fox, a board-certified vascular surgeon, performs UFE and sees patients at our Third Avenue office; for other options we’ll help you find the right specialist.
Start here
Do my fibroids need treatment?
Not always. Fibroids are noncancerous growths of the uterine muscle, and they are very common: ACOG estimates they occur in up to 70% of women by menopause, but only about a quarter cause problems serious enough to need treatment. Fibroids that cause no symptoms, are small, or appear in a woman who is nearing menopause often do not need treatment, and fibroids usually shrink after menopause.
ACOG lists these signs that treatment may be worth considering:
- Heavy or painful periods that cause anemia or disrupt your normal activities
- Bleeding between periods
- Pelvic pain or pressure
- Rapid growth of a fibroid
- Uncertainty about whether a growth is a fibroid or something else, such as an ovarian tumor
- Infertility
Size alone rarely decides it. What matters most is how your symptoms affect your life. The UK's NICE guideline asks doctors to recognize that heavy menstrual bleeding has a major impact on quality of life and to aim treatment at improving it, not just at the amount of blood lost. Our guide to fibroid size and when to treat explains this in more detail.
Get checked promptly if you have any bleeding after menopause, or a fibroid that grows after menopause or grows quickly at any age. These are not typical fibroid behavior and need a gynecologic evaluation before any fibroid treatment is planned.
Every option compared
Every fibroid treatment compared
Each option suits different fibroids and different plans. This table gives the headline differences; select a treatment to read the full comparison.
| Treatment | Uterus kept? | How it's done | Typical recovery | Chance of more treatment later | If you want a future pregnancy |
|---|---|---|---|---|---|
| Watchful waiting | Yes | No procedure. Your doctor may repeat imaging to track the fibroids over time. | None | Treatment can start later if symptoms appear or grow. Fibroids often shrink after menopause. | No treatment effect on pregnancy; discuss timing with your gynecologist. |
| Medication | Yes | Pills, injections, a hormonal IUD, or tranexamic acid taken during periods. | None | Fibroids stay in place. ACOG notes medication may not stop them growing and surgery is often needed later. | Hormonal birth control and the hormonal IUD prevent pregnancy while you use them. |
| Uterine fibroid embolization (UFE) | Yes | A catheter through a needle puncture at the groin or wrist; tiny particles block the fibroids' blood supply so they shrink. | About 1 to 2 weeks to normal activities for many women; up to 4 to 6 weeks for some. | Higher than surgery: about 1 in 3 needed another procedure within 5 years in the REST trial. | Pregnancies have been reported, but data are limited; myomectomy is usually discussed first. |
| Myomectomy (abdominal or laparoscopic) | Yes | Surgery to remove the fibroids through an abdominal incision or small keyhole incisions. | Longer than UFE in randomized trials; depends on the approach. | Lower than UFE, but new fibroids can develop and may need more surgery. | Usually the first choice if pregnancy is a priority; a cesarean birth may be needed later. |
| Hysteroscopic myomectomy | Yes | Through the cervix with a thin scope, for fibroids that bulge into the uterine cavity. No incision. | Usually no overnight stay; mild cramping and light bleeding for a few days are common. | It cannot reach fibroids deep in the uterine wall, and new fibroids can develop. | You may still be able to have children after myomectomy; ask your gynecologist about your case. |
| Hysterectomy | No | The uterus is removed through the abdomen, through small keyhole incisions or through the vagina. | Longest: in the EMMY trial, women returned to paid work after about 63 days, vs about 28 after UFE. | None for fibroids. | Pregnancy is no longer possible. |
| Radiofrequency ablation (RFA) | Yes | Heat from needles placed into each fibroid, through small keyhole incisions or through the cervix. | Days; in one study more than half of women were back to normal activity within a day. | About 8% to 11% by 3 years in single-arm studies. | ACOG says more research is needed on pregnancy after RFA. |
| MRI-guided focused ultrasound | Yes | Focused ultrasound waves heat the fibroids through the skin, guided by MRI. No incision. | Days; a median of 4 days off work in the FIRSTT trial, vs 8 after UFE. | Higher than UFE in the FIRSTT trial; ACOG notes more treatments may be needed. | Limited data. |
Figures come from different studies with different patients, so they are not direct head-to-head comparisons. Your fibroids' size, number and location decide which options are realistic for you.
UFE at Fox Vein Care
Uterine fibroid embolization at Fox Vein Care
The treatment Dr. Fox performs, in one page.
Dr. David Fox, a board-certified vascular surgeon (FACS, RPVI), performs uterine fibroid embolization (UFE), a catheter procedure that blocks the blood supply to fibroids so they shrink while the uterus stays in place. In randomized trials, women were as satisfied after UFE as after surgery and returned to their usual activities sooner, though more of them needed another procedure later, and the evidence on pregnancy afterward is limited. The full page covers results, candidacy, recovery, risks and insurance, with every number sourced.
Uterine Fibroid Embolization (UFE) in New York City
UFE in NYC with Dr. David Fox: a no-incision fibroid treatment that keeps the uterus. Results, recovery, fertility, risks and insurance, explained with sources.
Read the guideUnderstanding fibroids
What fibroids are and who gets them
Start here if you have just been told you have fibroids.
What Are Uterine Fibroids?
What uterine fibroids are, how common they are, who gets them, and when they need attention. A plain-language overview with ACOG and research sources.
Read the guideTypes of Fibroids: FIGO 0 to 8 Explained
The types of uterine fibroids, from submucosal to subserosal and pedunculated, the FIGO 0 to 8 system, and why fibroid location shapes symptoms and treatment.
Read the guideWhat Causes Fibroids? Risk Factors and the Evidence
No one knows exactly what causes fibroids. Learn how genes and hormones drive them, and which risk factors, such as age, race and family history, matter most.
Read the guideFibroids in Black Women: Risks, Symptoms and Options
Fibroids are more common and often more severe in Black women. Learn what research shows about why, how treatment patterns differ, and uterus-sparing options.
Read the guideAdenomyosis vs Fibroids: How to Tell Them Apart
Adenomyosis and fibroids both cause heavy, painful periods. Learn how they differ, how ultrasound and MRI tell them apart, and why it changes treatment options.
Read the guideCan Fibroids Turn Into Cancer?
Fibroids are benign and are not thought to turn into cancer. Learn how rare leiomyosarcoma is, what the FDA estimates, and which warning signs need a check.
Read the guideFibroids After Menopause: What Changes and What to Watch
Fibroids usually shrink after menopause. Learn why bleeding after menopause always needs a checkup, why new growth matters, and when treatment still helps.
Read the guideSymptoms and diagnosis
Symptoms, size and getting a diagnosis
What fibroids can do, when they matter, and how they are found.
Fibroid Symptoms: 9 Signs and When to See a Doctor
Nine common fibroid symptoms, from heavy periods and pelvic pressure to frequent urination and back pain, plus when to see a doctor and when to get urgent care.
Read the guideHeavy Periods and Fibroids: What Counts as Heavy
What counts as a heavy period, how fibroids cause heavy bleeding, tests to expect, treatment options, and when very heavy bleeding needs urgent care.
Read the guideFibroids and Anemia: Low Iron From Heavy Periods
How fibroids cause iron-deficiency anemia through heavy periods, which blood tests find it, how iron is replaced, and why treating the bleeding also matters.
Read the guideFibroids and Frequent Urination: Bladder Pressure
Why fibroids can press on the bladder and cause frequent or urgent urination, other causes to rule out, warning signs, and treatments that relieve pressure.
Read the guideCan Fibroids Cause Back and Leg Pain?
How fibroids can cause lower back pain, the rare ways they affect the legs, vein, artery and spine causes to rule out, and warning signs that need urgent care.
Read the guideFibroid Belly: Bloating and Enlargement
Why fibroids can make your belly look swollen or pregnant, how it differs from weight gain or bloating, warning signs, and how much treatment shrinks it.
Read the guideDegenerating Fibroid: Symptoms and When to Go to the ER
A degenerating fibroid has outgrown its blood supply and can cause sudden pelvic pain. Learn the symptoms, the pregnancy link, and when to go to the ER.
Read the guideFibroid Size: When Does a Fibroid Need Treatment?
Is your fibroid too big? There is no single size that means you need treatment. Learn why symptoms matter more, and when size changes your options.
Read the guideFibroid Diagnosis: Ultrasound vs MRI and What Each Shows
How fibroids are diagnosed: why pelvic ultrasound comes first, when an MRI with contrast is needed, and why MRI is usually done before fibroid embolization.
Read the guideComparing treatments
UFE compared with each alternative
Side-by-side guides for the decision you are facing.
Fibroid Medications: Options, Results and Limits
Fibroid medications compared: relugolix and elagolix pills, tranexamic acid, the hormonal IUD and more, with trial results, limits and when to consider UFE.
Read the guideUFE vs Myomectomy: What the FEMME Trial Shows
UFE vs myomectomy compared: quality of life, repeat treatment, recovery and pregnancy, from the FEMME trial, a Cochrane review and fertility studies.
Read the guideUFE vs Hysterectomy: 10-Year Results Compared
UFE vs hysterectomy: 10-year EMMY and 5-year REST trial results on quality of life, repeat treatment, hospital stay and return to work, and who fits each.
Read the guideUFE vs Radiofrequency Ablation (Acessa, Sonata)
UFE vs radiofrequency ablation for fibroids: how Sonata and Acessa compare with embolization on evidence, repeat treatment, recovery and insurance coverage.
Read the guideUFE vs Focused Ultrasound: FIRSTT Trial Results
UFE vs MR-guided focused ultrasound for fibroids: FIRSTT trial results on pain, time off work, 3-year relief and repeat treatment, plus insurance coverage.
Read the guideSubmucosal Fibroids: Hysteroscopy or UFE?
Submucosal fibroid treatment compared: when hysteroscopic myomectomy is the right first step, when UFE makes sense, and what expulsion after UFE means for you.
Read the guideIs UFE right for me?
Candidacy, fertility, results and risks
The questions most women ask before choosing UFE.
Am I a Candidate for UFE? A Practical Checklist
Who is a good candidate for uterine fibroid embolization, who should not have it, and which tests come first. A checklist built from CIRSE and ACOG guidance.
Read the guideUFE for Large Fibroids: How Much Do They Shrink?
Can UFE treat fibroids over 10 cm? What studies show about shrinkage, symptom relief and risk with large fibroids, and when surgery may be the better fit.
Read the guidePedunculated Fibroids and UFE: What the Evidence Shows
Can a fibroid on a stalk be treated with embolization? What studies show about safety, shrinkage and stalk width, and when surgery may be the simpler choice.
Read the guideEmbolization for Adenomyosis: What the Research Shows
Can uterine artery embolization treat adenomyosis? What the 2017 meta-analysis and the 2025 QUESTA study found, how it compares with hysterectomy, and who fits.
Read the guidePregnancy After UFE: What the Evidence Really Says
Can you get pregnant after uterine fibroid embolization? Honest numbers from trials and recent studies, how UFE compares with myomectomy, and what to ask first.
Read the guideWill UFE Cause Early Menopause? Risk by Age
Can uterine fibroid embolization cause early menopause? What CIRSE and trial data show about ovarian function, why risk rises after 45, and what to ask first.
Read the guideUFE Success Rate: What 1, 5 and 10-Year Studies Show
How well does uterine fibroid embolization work? Symptom relief, satisfaction and re-treatment rates from the FIBROID Registry, EMMY, REST and Cochrane.
Read the guideUFE Risks and Complications: The Real Numbers
The risks of uterine fibroid embolization with published rates: infection, tissue passage, early menopause, blood clots, and how UFE compares with surgery.
Read the guidePost-Embolization Syndrome After UFE: What Is Normal
Post-embolization syndrome after UFE: the cramping, low fever and nausea many women feel, how long it lasts, how it is treated, and which signs mean call now.
Read the guidePassing Fibroid Tissue After UFE: Fibroid Expulsion
Why some women pass fibroid tissue after UFE, who is most likely to (submucosal fibroids), how often a procedure is needed, and the warning signs to report.
Read the guideWho Performs UFE? Radiologists and Vascular Surgeons
Who performs uterine fibroid embolization: interventional radiologists usually, some vascular surgeons too. What FACS and RPVI mean, and questions to ask.
Read the guideFibroids or Pelvic Congestion? How to Tell Them Apart
Fibroids vs pelvic congestion syndrome: how the symptoms differ, which tests tell them apart, and how artery and vein embolization treat different problems.
Read the guidePlanning your UFE
Preparing, procedure day, recovery and cost
Practical guides for when you are ready to plan treatment.
Told You Need a Hysterectomy? Get a Second Opinion
Told you need a hysterectomy for fibroids? When a second opinion makes sense, when UFE is a real alternative, and when hysterectomy may still be the right call.
Read the guide15 Questions to Ask Before UFE
15 questions to ask before uterine fibroid embolization: the doctor's experience, setting, imaging, pain control, recovery, fertility, re-treatment and cost.
Read the guideHow to Prepare for UFE: A Checklist for the Weeks Before
A checklist to prepare for UFE: imaging and tests, medicines to review, insurance approval, what to bring, fasting, a ride home and setting up for recovery.
Read the guideWhat Happens During UFE: The Procedure Step by Step
What happens during UFE, step by step: sedation, the tiny wrist or groin puncture, X-ray-guided catheter, blocking both uterine arteries, and recovery room.
Read the guideIs UFE Painful? Cramping, Pain Control and What Helps
Is UFE painful? The procedure is done under sedation, but strong cramping afterward is expected. What studies show about pain and how it is controlled.
Read the guideUFE Recovery Day by Day: A Week-by-Week Timeline
How long UFE recovery takes, day by day: cramping in the first days, back to work in 1 to 4 weeks, and full results by about 6 months, with study numbers.
Read the guideIs UFE Covered by Insurance in New York?
Is UFE covered by insurance in New York? What Aetna and UnitedHealthcare policies say, prior authorization, records plans want, and how to appeal a denial.
Read the guideHow Much Does UFE Cost in NYC?
What UFE costs in NYC depends on insurance, setting, imaging, sedation and follow-up. See what drives the bill, your self-pay estimate rights, and study data.
Read the guideVisiting us
Visiting our Third Avenue office
Fox Vein & Vascular is at 1041 Third Avenue, New York, NY 10065, on the east side of Third Avenue between East 61st and East 62nd Streets, on the Upper East Side in the Lenox Hill area.
- Lexington Av/59 St (4, 5, 6, N, R and W trains): about a block west and two blocks south.
- Lexington Av/63 St: M and Q trains on weekdays; the F stops here on weekends and late nights.
Call (212) 362-3470 to book or to check current office hours. For your first visit, bring any ultrasound or MRI reports, a list of your medications and your insurance card. If you go on to have a procedure, plan for someone to take you home afterward.
Questions
Frequently asked questions
Which fibroid treatment is right for me?
It depends on your symptoms, the size, number and location of your fibroids, how close you are to menopause and whether you want a future pregnancy. ACOG supports watchful waiting if fibroids are not causing symptoms or you do not want treatment, and medication for heavy bleeding; a procedure is worth discussing when symptoms keep affecting daily life.
Do I need to see a gynecologist first?
A gynecologic evaluation is part of planning any fibroid procedure, to confirm that fibroids explain your symptoms and rule out other causes of bleeding. If you already have a gynecologist, we work alongside them; if you have imaging, bring the report.
What should I bring to my first visit?
Bring any pelvic ultrasound or MRI reports, recent blood test results if you have them, a list of your medications and your insurance card. A note of how heavy and how long your periods are also helps.
Which subway stations are closest to your office?
Lexington Av/59 St (4, 5, 6, N, R and W trains) is about a block west and two blocks south. Lexington Av/63 St is served by the M and Q on weekdays and the F on weekends and late nights.
Can I try medication before having a procedure?
Often, yes. ACOG supports options such as tranexamic acid, a hormonal IUD and newer GnRH antagonist pills with add-back hormones, which can be used for up to 2 years. Medication can ease bleeding but does not remove fibroids, and some women go on to need a procedure later.
Will insurance cover fibroid treatment?
UFE is an established treatment and is generally covered when fibroids cause symptoms; Aetna, for example, considers it medically necessary for persistent fibroid symptoms. Plans differ, and some require prior authorization. Check with your plan and ask our office to verify your benefits before any procedure.
Sources
Research behind this guide
- ACOG Practice Bulletin No. 228, 2021 — Management of Symptomatic Uterine Leiomyomas
- ACOG patient FAQ — Uterine Fibroids
- ACOG patient FAQ — Uterine Artery Embolization
- ACOG patient FAQ — Hysteroscopy
- ACOG patient FAQ — Hysterectomy
- ACOG Committee Opinion No. 734, 2018 — The role of transvaginal ultrasonography in evaluating the endometrium of women with postmenopausal bleeding
- NICE guideline NG88 — Heavy menstrual bleeding: assessment and management
- Aetna Clinical Policy Bulletin 0304 — Fibroid Treatment
- RadiologyInfo (ACR/RSNA) — Uterine Fibroid Embolization
- van Overhagen & Reekers, CIRSE Standards of Practice, 2015 — Uterine artery embolization for symptomatic leiomyomata
- Gupta et al., Cochrane Database of Systematic Reviews, 2014 — Uterine artery embolization for symptomatic uterine fibroids
- Moss et al., BJOG, 2011 — 5-year results of the REST trial (UAE vs surgery)
- Volkers et al., Cardiovascular and Interventional Radiology, 2006 — EMMY trial: return to work after UAE vs hysterectomy
- Mara et al., Cardiovascular and Interventional Radiology, 2008 — Randomized trial of uterine artery embolization vs myomectomy
- Chudnoff et al., Obstetrics & Gynecology, 2019 — Transcervical radiofrequency ablation of fibroids: SONATA 12-month results
- Lukes & Green, Journal of Gynecologic Surgery, 2020 — SONATA 3-year results
- Berman et al., Journal of Minimally Invasive Gynecology, 2014 — Laparoscopic radiofrequency ablation of fibroids: 3-year outcomes
- Barnard et al., American Journal of Obstetrics and Gynecology, 2017 — FIRSTT trial: UAE vs MRI-guided focused ultrasound, periprocedural outcomes
- Laughlin-Tommaso et al., American Journal of Obstetrics and Gynecology, 2019 — FIRSTT 36-month results
- New York State Open Data — MTA Subway Stations
- MTA — F/M swap (service at Lexington Av/63 St from December 8, 2025)
Speak with a specialist
Talk through your fibroid treatment options
Tell us what you’d like to discuss and our team will be in touch.
Prefer to talk? Call (212) 362-3470.
This page brings together general information from our articles and is not a substitute for a medical evaluation. Dr. Fox will recommend a treatment plan based on your individual needs.