At some point a doctor looked at your chart and said the word hysterectomy, and now you’re sitting with a decision you didn’t ask for.

Is there any way to treat fibroids and still keep the uterus?

A fibroid (a benign, non-cancerous growth of muscle tissue in the wall of the uterus) can be smaller than a grape or larger than a grapefruit. If a fibroid sits against your bladder, you wake up at night needing the bathroom. If one grows into the lining, you get the soaking you’ve been managing around your calendar.

You do have two real paths forward, and both are legitimate depending on what your imaging shows and what you still want from your body. One is uterine fibroid embolization (UFE), a procedure that blocks the blood supply feeding fibroids so they shrink, done through tiny punctures instead of large surgical cuts, and it leaves your uterus in place.

The other removes the uterus and ends fibroid symptoms permanently.

Key Takeaways

• UFE and hysterectomy treat fibroids in two very different ways.
• UFE keeps your uterus in place, but hysterectomy removes it for good.
• Recovery is faster with UFE, often one to two weeks versus four to six weeks for hysterectomy.
• UFE’s risks are mostly minor and short-lived, while hysterectomy carries the risks of major surgery and general anesthesia.
• UFE doesn’t rule out future pregnancy, but if you’re actively trying to conceive, myomectomy is usually recommended first.

Comparing Your Two Options

Keeping your uterus and getting back on your feet within a week sits on one side. Removing the uterus and never dealing with fibroid symptoms again sits on the other.

Factor	UFE	Hysterectomy
What it does	Blocks blood supply feeding fibroids so they shrink	Removes the uterus completely
Incisions	One pinhole access point at the wrist or groin	Vaginal incision, small camera incisions, or one larger abdominal incision
Anesthesia	Light sedation, no general anesthesia needed	General anesthesia
Hospital stay	Usually same-day discharge	Usually 1 to 2 days or more, depending on approach
Return to work	Often within 1 to 2 weeks	Often 4 to 6 weeks or longer
Uterus preserved	Yes	No
Periods after	Periods continue, often lighter	Periods stop for good
Chance of needing more treatment	About 15% to 32% within 2 years, per one meta-analysis	About 7% within 2 years, per the same meta-analysis
Who performs it	Interventional radiologist	Gynecologic surgeon

UFE goes in through a pinhole and gets you home the same day, while hysterectomy means a hospital stay and weeks of lifting restrictions afterward.

UFE patients recover faster, and research backs it up: women who had UFE spent less time in the hospital and got back to normal activity faster than women who had surgery.

Removing the uterus ends fibroid symptoms permanently, because there’s nothing left for a fibroid to grow in. Keep the uterus, though, and new fibroids can develop later.

An interventional radiologist performs UFE, working through your blood vessels with imaging as a guide, while a gynecologic surgeon performs a hysterectomy in an operating room. Whichever doctor you’re sitting across from tends to recommend what they do every day.

How the fibroid procedure works

UFE treats fibroids by cutting off the blood they’ve been feeding on, so they shrink and stop causing symptoms while your uterus stays exactly where it is. UFE is performed by an interventional radiologist, a doctor working inside your blood vessels using live imaging instead of opening the belly.

Interventional radiology (a specialty that uses imaging like x-ray and ultrasound to guide thin tools through the body’s own blood vessels) is what makes that possible.

A fibroid grows because arteries keep pumping blood into it. Dr. Karen Garby explains that the interventional radiologist blocks the artery branches feeding the fibroid with tiny, permanent spheres.

1. Pinhole access. The interventional radiologist makes a tiny opening at the wrist or groin, no larger than a pinhole. No incision is needed.
2. Catheter guided to the uterine arteries. Using x-ray guidance, the radiologist threads a thin tube through the blood vessels until it reaches the arteries feeding the fibroids.
3. Tiny particles block the blood flow. Small particles are released through the catheter and lodge in the small vessels, cutting off the fibroid’s blood supply, similar to closing a valve on a garden hose.
4. Fibroids shrink over 3 to 6 months. Without blood flow, fibroid tissue shrinks and turns into scar tissue, which typically eases bleeding and pressure symptoms over the following months.

Most women go home that same afternoon, but the shrinking itself isn’t instant. The fibroid shrinks gradually over three to six months afterward, so relief builds over that time instead of showing up the day you leave the office.

How a hysterectomy works

A hysterectomy takes the uterus out entirely, which is exactly why fibroid symptoms can’t return afterward. It’s a surgical procedure done by a surgeon under general anesthesia.

The cervix sometimes comes out along with it, and your ovaries may stay in place or come out too, depending on what you and your surgeon decide beforehand.

The surgeon can go through the vagina with no visible incision, through a handful of small openings guided by a camera, or through one larger cut across the belly when more room is needed.

You’ll be fully asleep under general anesthesia while the surgeon operates, and you’ll typically stay in the hospital at least overnight before heading home. Before you agree to any of it, ask your surgeon two things: whether your ovaries are staying, and which of the three routes they’re planning to use.

Recovery Timelines Compared

UFE typically sends you home the same day or the ext, with most women back to their routine inside one to two weeks.n

Hysterectomy means a hospital stay first, then a slower climb back to normal, often four to six weeks before you’re cleared for golf, a hike, or lifting a grandchild.

The first week after UFE usually brings strong cramping for a few days as the fibroid loses its blood supply, followed by fatigue that fades gradually. Ask your interventional radiologist what pain medication you’ll go home with and how long you should expect to need it. By the second week, most women are easing back into their normal days without much thought.

Hysterectomy recovery requires more of you upfront. Expect no lifting and no driving for a stretch. A full return stretches longer if your surgeon needed the larger abdominal opening rather than one of the smaller-incision approaches, since UFE patients see a faster return to usual activity by comparison.

Does the procedure actually work?

Most women who have UFE get real relief from the bleeding and pressure that brought them into the office in the first place. Guidelines from the Society of Interventional Radiology say about 90% of women can expect less bulk and pressure afterward, and more than 90% can expect heavy bleeding to stop or ease.

Study or guideline	What it measured	Finding
SIR guidelines	Symptom improvement	About 90% reduced bulk symptoms, and over 90% saw abnormal bleeding stop
2025 submucosal fibroid study (155 patients)	Fibroid shrinkage and need for further treatment	64% median volume reduction, and 84.5% needed no further treatment
10-year EMMY trial follow-up	Long-term need for hysterectomy	33% of UFE patients eventually had a hysterectomy, vs. 8% of hysterectomy patients needing a second procedure
Gupta et al. meta-analysis	Further surgery within 2 years	15% to 32% for UFE, vs. 7% for hysterectomy or myomectomy

Most women get relief quickly, and roughly one in three go on to choose a hysterectomy over the following decade when new symptoms appear. Women past 45 and women whose fibroids sit in certain locations are the most likely to fall into that third, which is why your imaging and your age both belong in the conversation.

Keeping your uterus means quicker relief and less downtime today, but it also means a real chance you’re back in an office years later weighing treatment again.

Risks of each option

UFE tends toward short-lived discomfort and small infection risks. Hysterectomy carries the risks that come with any operation and general anesthesia. Reported complication rates for UFE swing widely across studies, from as low as 5% to as high as 40%, largely because some studies count every minor issue while others count only the serious ones.

Procedure risks

In the days after UFE, cramping and flu-like achiness are common, and they pass. A small share of women develop an infection. A 2025 study of 155 women found serious problems in just 3.2%, mostly pelvic infections, while milder issues like infections treated with antibiotics or lasting discharge showed up in 16.8%. Rarely, ovarian function changes or a woman needs further treatment down the line.

Hysterectomy risks

Hysterectomy carries the risks that come with any operation: bleeding, infection, injury to nearby organs, and blood clots, plus longer exposure to general anesthesia. If your ovaries come out along with the uterus, you’ll enter menopause immediately.

In the REST trial comparing the two directly, minor complications were more common after UFE than after surgery (34% versus 20%), while UFE still meant a shorter hospital stay and less pain in the first day. That higher minor-complication number covers things like cramping and short-lived discharge rather than hospital returns.

Long-term effects to ask about

Ask either doctor what happens to your periods, and what changes for your bladder and pelvic floor once the uterus is gone. Periods stopping altogether after UFE happens in fewer than 10% of cases, and it’s far more likely if you’re over 45. Bring both questions into whichever consultation you have next.

Fertility and Future Pregnancy

Pregnancy does happen after UFE, while removing the uterus ends the possibility for good, so if having a baby is still part of your plan, myomectomy usually becomes the stronger option. It removes the fibroids but leaves the uterus in place.

A 2017 study in Radiology followed 359 women with fibroids who’d previously been unable to conceive. Over the following six years, 41.5% became pregnant at least once, and 131 gave birth.

Even so, doctors typically steer women who are actively trying to conceive toward myomectomy instead of UFE, because head-to-head numbers favor it. In one trial of fibroids larger than 4 cm, 50% of women conceived after UFE compared with 78% after myomectomy.

Myomectomy is a real surgical procedure with its own recovery, and fibroids can return afterward, but if pregnancy is the near-term goal, say that out loud at your consultation.

Other treatments worth knowing

Some take the fibroids out, some shrink them with heat or sound, and some just quiet the bleeding without touching the fibroid at all.

Approach	Pros	Cons	Best for
Myomectomy	Removes fibroids, keeps the uterus, and is recommended first for fertility	Surgical procedure with recovery time, and fibroids can return	Women actively trying to conceive
Radiofrequency ablation	Symptom severity scores improved 82% in one study, done outpatient	10.4% needed a repeat procedure within 36 months in a pivotal trial	Women done with childbearing who want a shorter procedure
MRI-guided focused ultrasound	No incision, uses sound waves to shrink fibroids	Higher reintervention rate and less quality-of-life improvement than UFE per one review, and limited availability	Women who qualify anatomically and have access to the technology
Hormonal IUD or medication	Non-surgical, can reduce bleeding significantly	Doesn’t shrink fibroids, and effects often stop when treatment stops	Women who want a temporary, non-surgical way to manage bleeding

Myomectomy

Myomectomy takes the fibroids out and leaves your uterus behind, but it’s still surgery with real recovery time, and fibroids can grow back later. It’s the option worth discussing first if pregnancy is still on the table, for the reasons already covered above.

Heat and Sound Treatments

Radiofrequency and transcervical ablation cook fibroids down from the inside using heat, while MRI-guided focused ultrasound does the same job with sound waves passed through the skin. In one transcervical ablation trial of 50 women, total fibroid volume dropped 66.6% at one year, and 8% needed further surgery.

Focused ultrasound has shown more repeat treatments and less improvement in quality of life compared with blocking the fibroid’s blood supply directly, and availability is limited to centers with the right equipment.

Medication and Hormonal IUDs

A hormonal IUD thins the uterine lining and can meaningfully lighten a heavy period, but it doesn’t shrink the fibroid causing it. Gonadotropin-releasing hormone (GnRH) medications shrink fibroids, but only for as long as you’re taking them, and symptoms typically return once you stop.

When a hysterectomy is still right

• A suspected or confirmed cancer diagnosis
• Bleeding that has failed every other treatment
• Fibroids sitting where nothing else can reach them
• Simply being done and wanting one permanent fix

University of Calgary researchers found nearly one in three Canadian women 60 and older have had a hysterectomy. Rates varied enough between education groups, 29.7% versus 14.7%, to suggest some of those procedures were avoidable.

Cost and Insurance Coverage

Insurance typically covers both UFE and hysterectomy as established medical treatments for fibroids, so coverage itself usually isn’t the deciding factor. What you owe out of pocket depends on your specific plan.

Your own share comes down to your deductible, your coinsurance, whether the facility is in network, and whether your plan requires advance approval before scheduling. Have the office verify your benefits and handle any prior authorization, and ask exactly what the consultation with Prescott interventional radiologists includes, so you know the actual cost beforehand.

Which option fits your situation?

If pregnancy is still part of your plan, myomectomy is the stronger first move, for the reasons already covered.

UFE tends to fit better when your family is complete and you need to get back to work and to your normal life fast. Hysterectomy may be the more realistic path if your fibroids are severe and other treatments have already failed you.

Close to menopause, you may only need to get through a few more years of bleeding rather than decades, and that shifts the case away from a permanent procedure.

An ultrasound or MRI (a scan that uses magnets to picture soft tissue inside the body) shows your fibroids’ size and location, and your doctor works from those findings before preference matters. Those findings are also what determine candidacy, so ask directly whether anything on your imaging rules UFE out for you.

Questions to ask before surgery

• Why is this option being recommended for me specifically?
• Am I a candidate for UFE?
• Who reviewed my ultrasound or MRI?
• What happens if I wait six months and reassess?
• What does recovery really look like, week by week?
• Will my ovaries be affected by either option?
• What’s the chance I need further treatment later?
• What will this cost me under my insurance plan?
• Is there a non-surgical option I haven’t been told about?

The Question Worth Asking Before You Sign Anything

Ask what else your imaging allows before you agree to a hysterectomy. Your bleeding and pressure are worth treating, and you have more than one real way to treat them.

If your imaging allows it, keeping your uterus can mean relief through a pinhole and a return to hiking, golf, or a full night’s sleep within a week or two. Hysterectomy is still there later if symptoms come back.

A consultation doesn’t commit you to anything. Bring whatever ultrasound or MRI you already have, ask whether your plan needs a referral from your primary doctor, and expect a visit built around reviewing your imaging and explaining your options.

Have a fibroid specialist look at your ultrasound or MRI and walk through both paths with you before you agree to surgery. Call (928) 771-8477 to schedule that consultation.

Frequently Asked Questions

Can you get pregnant after UFE?

Yes, pregnancy can happen after UFE. A study following women who’d previously struggled to conceive found 41.5% became pregnant within six years of treatment.

Is hysterectomy the only option for heavy or abnormal uterine bleeding?

No. UFE (uterine fibroid embolization) blocks the blood supply feeding fibroids, shrinking them without removing the uterus. About 90% of women see less pressure, and over 90% see heavy bleeding stop or ease.

What are the alternatives to hysterectomy for adenomyosis or bulky fibroids?

Adenomyosis is a condition where uterine lining tissue grows into the muscular wall of the uterus. Myomectomy removes fibroids surgically and keeps the uterus, while UFE shrinks fibroids by cutting off their blood supply through a pinhole access point. Radiofrequency ablation is another option using heat instead of surgery.

Are there alternatives to hysterectomy for endometrial hyperplasia or early-stage endometrial cancer?

Endometrial hyperplasia means the lining of the uterus has grown abnormally thick. A hormonal IUD can thin the uterine lining and reduce bleeding tied to hyperplasia, though it doesn’t address a fibroid’s blood supply. Hysterectomy typically becomes the recommended path once cancer is confirmed.

Why is UFE underutilized compared to hysterectomy?

Doctors tend to recommend the treatment they perform every day, and gynecologic surgeons don’t always mention UFE. Hysterectomy rates vary widely by education and region, suggesting many procedures may be avoidable.

Should I get a second opinion before agreeing to a hysterectomy for fibroids?

Yes. A second opinion means having a fibroid specialist review your imaging before you sign anything. It can reveal whether UFE or myomectomy fits your case.

How does UFE actually shrink a fibroid?

An interventional radiologist threads a thin tube to the artery feeding the fibroid and releases tiny particles that block blood flow, similar to closing a valve on a hose. The fibroid shrinks into scar tissue over three to six months.

How long is recovery after UFE compared to hysterectomy?

UFE recovery usually takes one to two weeks, with most women home the same day. Hysterectomy recovery runs four to six weeks, often starting with an overnight hospital stay.

Do fibroids come back after UFE?

A treated fibroid doesn’t return since it turns into permanent scar tissue. New fibroids can develop later, and about a third of women eventually choose hysterectomy for new symptoms within ten years.