Post-embolization syndrome is the group of flu-like symptoms many women feel in the first few days after uterine fibroid embolization: pelvic pain and cramping, a low-grade fever, nausea, loss of appetite and a general unwell, tired feeling. It is caused by inflammation as the fibroid tissue loses its blood supply. It is expected, it usually settles over days, and it is treated with medication. What matters is knowing the difference between this normal reaction and signs of a problem, such as infection.
For a full overview of the procedure itself, see our main page on uterine fibroid embolization (UFE).
What post-embolization syndrome is
During UFE, tiny particles block the small arteries feeding the fibroids. Without blood flow, the fibroid tissue begins to die and shrink. A 2021 review by interventional radiologists at Emory University explains that this tissue loss triggers inflammation, and the body's response to that inflammation is what you feel as post-embolization syndrome (often shortened to PES).
The CIRSE 2015 guideline defines it as pelvic pain, low-grade fever, nausea, vomiting, loss of appetite and malaise in the first few days after the procedure. The Emory review adds that blood tests can show a raised white blood cell count, which is part of the same inflammatory response.
How common is it?
Some degree of these symptoms is very common. The Emory review describes post-embolization syndrome as something experienced by the majority of patients who have UFE.
Published rates vary widely because studies define the syndrome differently. A 2022 systematic review found reported rates ranging from 4% to 34.6% across the studies that measured it, and called for a shared definition. The CIRSE 2015 guideline lists post-embolization syndrome as a complication in 3% of procedures, which refers to cases severe enough to count as a complication, not to the mild, expected version. So if you feel unwell for a few days, that alone does not mean anything has gone wrong.
What it feels like and how long it lasts
| Timing | What published sources describe |
|---|---|
| First hours | Pelvic pain usually worsens over the first 2 to 3 hours and then stays fairly steady for about 12 hours (Emory review, 2021) |
| First day | Cramps are most severe during the first 24 hours (RadiologyInfo) |
| Days 2 to 3 | Fever, nausea and fatigue can peak around this time (Emory review, 2021) |
| Up to 2 weeks | Abdominal pain and cramps may continue, gradually easing (ACOG patient FAQ) |
Everyone's course is a little different. Some women feel mostly better within a few days, while others feel tired and crampy for longer. For a broader week-by-week picture of getting back to work and exercise, see our UFE recovery timeline.
Questions about your treatment options? Dr. Fox can help.
Book a ConsultationThis article is part of our Fibroid Treatment Guide.
How it is managed
Because post-embolization syndrome is expected, most UFE programs plan for it in advance. According to the Emory review:
- Anti-inflammatory medicines (NSAIDs) are an essential part of managing pain after UFE, because they target the inflammation directly.
- Opioid pain medicine is often prescribed for use as needed, because some clinicians find NSAIDs alone are not enough in the first days.
- Anti-nausea medicine and a bowel regimen are commonly added, since nausea is part of the syndrome and opioids can cause constipation.
- Steroids: some programs, including the Emory team, give a dose of a steroid such as dexamethasone around the time of the procedure to reduce inflammation.
Some programs also use a nerve block during the procedure; in a 2018 randomized trial of 44 women, a superior hypogastric nerve block reduced the pain medicine needed right after UFE. Each team has its own approach, so ask what medicines you will go home with and how to take them. Our article on whether UFE is painful covers pain control in more detail.
At home, rest is reasonable for the first few days. Take your medicines on the schedule your doctor gives you rather than waiting for pain to build up, and keep track of your temperature so you can report it accurately if you need to call.
Normal vs time to call
First, what is usually expected. RadiologyInfo describes pelvic cramps for several days after UFE, along with mild nausea and a low-grade fever, and the CIRSE 2015 guideline adds loss of appetite and a general feeling of being unwell. Feeling tired and wanting to stay close to home for a few days fits this picture. These symptoms should respond, at least partly, to the medicines you were sent home with.
The tricky part is that some signs of post-embolization syndrome, like fever and pain, can also be signs of infection or another complication. ACOG says that pelvic pain is normal after UAE, and so is a low fever. It advises calling your doctor if you have:
- Pain so severe that medication does not help
- A fever higher than 101 °F
- Nausea or vomiting
- Bleeding or pain where the catheter was inserted
- A change in color or temperature of either of your legs
Different programs use slightly different fever thresholds, so follow the number on your own discharge instructions if it differs. As a general rule, symptoms of post-embolization syndrome should be easing as the days go by. A fever that climbs, pain that gets worse instead of better, or symptoms that return after you had started to feel better are reasons to call your care team rather than wait.
If you cannot reach your team and feel very unwell, go to an emergency department and tell the staff you recently had uterine artery embolization, so they can consider complications of the procedure.
Post-embolization syndrome vs infection
Infection after UFE is much less common than post-embolization syndrome. The CIRSE 2015 guideline reports major infection in 2.5% of procedures and discharge with fever in 4%. Because the symptoms can overlap, doctors decide between the two based on how high the fever is, how you are trending, your exam and sometimes blood tests or imaging. You do not need to make that call yourself. Your job is to report symptoms that cross the thresholds above.
Passing pieces of fibroid tissue can also cause cramping and discharge, sometimes later in recovery. That is a separate event, explained in passing fibroid tissue after UFE. For a full list of risks with published rates, see UFE risks and complications.
Planning ahead
A little preparation makes the first few days easier:
- Arrange for someone to take you home and, ideally, to stay with you the first night.
- Plan several days off work and away from caregiving duties if you can.
- Ask before the procedure which medicines you will take home and what fever threshold should prompt a call.
- Save your care team's daytime and after-hours numbers in your phone.
If you are still deciding whether UFE is right for you, our fibroid treatment guide compares it with medication, myomectomy, hysterectomy and other options.
Frequently Asked Questions
Is post-embolization syndrome normal after UFE?
Yes. A 2021 review describes it as something the majority of UFE patients experience. Pelvic pain and a low fever are expected in the first days and are treated with medication.
How long does post-embolization syndrome last?
Pain is usually strongest in the first day. Fever, nausea and tiredness can peak around days 2 to 3, and ACOG says cramps can continue for up to 2 weeks while gradually easing.
What fever is too high after UFE?
ACOG advises calling your doctor for a fever higher than 101 °F. Some programs use a different number, so follow your own discharge instructions if they differ.
How do I know if it is an infection instead?
You do not have to tell them apart yourself. Call your care team for a fever above your threshold, pain that is getting worse instead of better, or symptoms that come back after improving, and they will assess you.
Can post-embolization syndrome be prevented?
Not entirely, because it comes from the treatment itself. Programs reduce it with anti-inflammatory medicines, as-needed pain medicine, anti-nausea medicine and, in some programs, a steroid dose or nerve block around the time of the procedure.
Keep Reading
- Uterine Fibroid Embolization (UFE) in New York City
- UFE Recovery Day by Day: What to Expect Week by Week
- Is UFE Painful? What the Pain Feels Like and How It Is Controlled
- UFE Risks and Complications: What the Numbers Show
- Passing Fibroid Tissue After UFE: Why It Happens and When to Call
- How to Prepare for UFE: Your Checklist From Consultation to Procedure Day
- Fibroid Treatment Guide: every option, compared
Sources
- van Overhagen and Reekers, Cardiovasc Intervent Radiol, 2015 — CIRSE standards of practice for uterine artery embolization
- Chan et al., Semin Intervent Radiol, 2021 — managing post-embolization syndrome pain after UFE
- Waldron et al., Diagnostics (Basel), 2022 — systematic review of post-embolisation syndrome after UAE
- ACOG patient FAQ — Uterine Artery Embolization (last reviewed May 2026)
- RadiologyInfo.org (ACR/RSNA) — Uterine Fibroid Embolization
- Yoon et al., Radiology, 2018 — randomized sham-controlled trial of superior hypogastric nerve block for UFE pain (44 women)
Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.
Living with heavy periods, pelvic pressure or other fibroid symptoms? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether uterine fibroid embolization is right for you. Call (212) 362-3470 or request a UFE consultation online.
