Will UFE Cause Early Menopause? Ovarian Function and Age

For most women, uterine fibroid embolization (UFE) does not cause early menopause. The CIRSE 2015 guideline reports that periods stop after UFE in about 4% of women and stop permanently in less than 2%. The risk depends strongly on age. It is low under 40 and noticeably higher after 45, when the ovaries are already winding down. In the US FIBROID Registry, 86% of the women whose periods stopped after UFE were 45 or older.

Why UFE can affect the ovaries at all

UFE blocks the small arteries feeding fibroids by releasing tiny particles into the uterine arteries. In some women, the uterine and ovarian arteries are connected, so some particles may reach the ovary and reduce its blood supply. The CIRSE 2015 guideline lists a shared arterial supply of the uterus and ovaries as a relative contraindication for this reason, and notes that embolization of the ovaries "can lead to premature menopause especially in women older than 45 years of age."

A woman in her 20s or 30s has a large reserve of eggs, so a small reduction may not matter much. A woman in her late 40s has far fewer left, so the same effect can be enough to tip her into menopause sooner than it would otherwise happen.

The risk by age: what studies show

The Chrisman study is often quoted because its number is striking, but it was small, short and done in the early years of UFE. The larger and more recent sources put the overall risk far lower. The pattern they all share is the age effect: the closer you are to natural menopause, the more likely UFE is to bring it forward.

What hormone tests show about egg supply

Doctors measure ovarian reserve, meaning the remaining egg supply, with blood tests such as AMH (anti-Müllerian hormone) and FSH (follicle-stimulating hormone).

• A 2020 review of 6 studies (353 women) found no significant change in AMH or FSH after UFE, including when women under and over 40 were looked at separately. Two small studies did find fewer visible egg follicles on ultrasound at 3 months.
• The EMMY trial, which randomized 177 women to UFE or hysterectomy, found FSH rose in both groups over 2 years, with no difference between them. AMH stayed lower than expected for age only after UFE, but again with no significant difference between the groups. The authors concluded that "both UAE and hysterectomy affect ovarian reserve," so older women in either group may reach menopause sooner.
• The FEMME trial found no difference in ovarian reserve hormones between UFE and myomectomy at 4 years.
• The FIRSTT trial found a larger drop in AMH at 2 years after UFE than after focused ultrasound, a treatment that does not involve the arteries.

Put together, the evidence suggests a small average effect, larger in older women, and similar in size to the effect of hysterectomy in one trial. It does not support the idea that UFE routinely damages the ovaries in younger women.

This article is part of our Fibroid Treatment Guide.

What these numbers mean for you

Turned into everyday terms, the CIRSE figures mean that about 4 in 100 women stop having periods after UFE, and fewer than 2 in 100 stop for good. The US Office on Women's Health describes complications of UFE, "including early menopause," as uncommon. For a woman in her 30s, the studies above found the chance to be low.

For women 45 or older, the picture changes. Spies and colleagues estimated about a 15% chance that FSH, a hormone that rises as the ovaries slow down, moves into the perimenopausal range. A rise in FSH is not the same as menopause, but it shows the ovaries are closer to it. If you are in this age group, it is reasonable to ask your doctor how your own age, cycle pattern and any hormone results change the odds for you.

Missed periods vs menopause

After UFE, periods sometimes pause and then come back. The CIRSE figures (about 4% with no periods, under 2% permanently) imply that for some women the pause is temporary. If your periods have not returned within a few months, or you develop hot flashes or night sweats, tell your doctor. Hormone tests can help show whether you are in menopause or whether something else is going on. Bleeding that starts again after you have been in menopause always needs prompt evaluation.

If you are over 45

This is where the decision needs the most thought. A few points to weigh:

• Fibroids usually shrink after menopause. ACOG and the US Office on Women's Health both note this. If your symptoms are manageable and you are close to menopause, waiting can be a reasonable choice. See fibroids after menopause.
• For some women, periods stopping is welcome. If heavy bleeding is the main problem and you do not want more children, an earlier end to periods may not feel like a loss. It does bring the usual effects of menopause, such as hot flashes, sooner, so it is worth discussing.
• Hysterectomy is not free of this effect either. In EMMY, ovarian hormone changes were similar after both treatments.
• Bleeding needs a proper workup. At this age, heavy or irregular bleeding should be checked for causes other than fibroids before any treatment.

If you still want to become pregnant, the ovarian question is only part of the picture. See pregnancy after UFE for the full evidence.

Questions to ask your doctor

• Given my age, what is my realistic chance of my periods stopping for good?
• Would you check my hormone levels before UFE?
• What would you do if the imaging during the procedure showed a connection to the ovarian arteries?
• Am I close enough to menopause that waiting is a reasonable option?
• How would an earlier menopause affect my bones and heart health, and what could I do about it?

For a broader look at who is suited to UFE, see am I a candidate for UFE? For results, risks and recovery, see our guide to uterine fibroid embolization (UFE), and to compare every option, see our fibroid treatment guide.

Frequently Asked Questions

How common is early menopause after UFE?

Uncommon. The CIRSE 2015 guideline reports periods stopping in about 4% of women and permanently in less than 2%. Most of these women are 45 or older.

Does UFE lower AMH or egg supply?

A 2020 review of 6 studies found no significant change in AMH or FSH after UFE. Some individual trials found modest drops, mostly mattering for women already near menopause.

I am 47. Should I still consider UFE?

Possibly. Your chance of periods stopping is higher at this age, and fibroids often shrink after menopause, so waiting can be reasonable. Discuss your symptoms, your goals and your bleeding workup with your doctor.

Is hysterectomy better for protecting the ovaries?

Not clearly. In the EMMY trial, FSH rose after both UFE and hysterectomy with no difference between the groups, and the authors concluded that both affect ovarian reserve.

My periods stopped after UFE. Is that menopause?

Not necessarily. Periods sometimes pause and then return. If they have not come back after a few months, or you have hot flashes, your doctor can check hormone levels.

Keep Reading

• Uterine Fibroid Embolization (UFE) in New York City
• Pregnancy After UFE: Honest Numbers and What They Mean
• Am I a Candidate for UFE? A Practical Checklist
• Fibroids After Menopause: What Changes and What to Watch For
• UFE Risks and Complications: What the Numbers Show
• UFE vs Hysterectomy: What 10 Years of Trial Data Show
• Fibroid Treatment Guide: every option, compared

Sources

1. van Overhagen & Reekers, Cardiovasc Intervent Radiol, 2015 — CIRSE Standards of Practice: uterine artery embolization for symptomatic leiomyomata
2. Spies et al., Obstet Gynecol, 2005 — FIBROID Registry 1-year outcomes (2,112 patients)
3. Spies et al., J Vasc Interv Radiol, 2001 — ovarian function after UAE assessed by FSH (63 women)
4. Chrisman et al., J Vasc Interv Radiol, 2000 — resumption of menses and ovarian function after UFE (66 women)
5. El Shamy et al., Acta Obstet Gynecol Scand, 2020 — impact of UAE on ovarian reserve: systematic review and meta-analysis (6 studies, 353 women)
6. Hehenkamp et al., Hum Reprod, 2007 — ovarian reserve after UAE vs hysterectomy (EMMY, 177 women)
7. Daniels et al., Int J Gynaecol Obstet, 2023 — FEMME trial 4-year outcomes, UAE vs myomectomy
8. Laughlin-Tommaso et al., Am J Obstet Gynecol, 2019 — FIRSTT trial 36-month results, UAE vs focused ultrasound
9. ACOG patient FAQ, Uterine Fibroids (last reviewed December 2025)
10. Office on Women's Health, Uterine fibroids (updated February 2025)

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.