If you have symptomatic uterine fibroids, chances are you pushed through heavy periods, pain, or constant bloating for a while before finally getting a diagnosis. You’re not alone. Women are often told their disruptive symptoms are a normal part of their cycle, and 3.6 years is the average time they wait before seeking treatment.¹

Putting a name to your experience likely offered some relief, but as you research treatment options, you may feel overwhelmed by choices. In addition to non-surgical methods like birth control pills or an IUD, advances in medicine have led to the creation of minimally invasive options that can address a range of fibroid types, sizes, and severity.

Among the procedures are uterine fibroid embolization (UFE), also known as uterine artery embolization (UAE), and radiofrequency ablation (RFA). If you’re considering one of these treatments, it’s important to understand the differences in how they are performed, potential side effects, and recovery time, as these factors could impact your decision.

What is uterine fibroid embolization?

UFE and UAE are essentially the same procedure, with UFE being a type of UAE that blocks blood flow to fibroids, which causes them to shrink.² During the procedure, a small incision is made for a catheter that delivers a compound of gel or plastic to an artery. Instead of targeting each fibroid individually, the gel or plastic compound stops blood flow from some of your arteries to your uterus. The lack of blood supply causes fibroids to shrink over time, which helps relieve symptoms.³

While UFE is less invasive than major surgery, recovery may be uncomfortable. Many women experience moderate to severe cramping, and some develop a common condition called post-embolization syndrome. Symptoms of post-embolization syndrome can include pain, fever, nausea, and fatigue that could last up to a week. Other risks associated with UFE include an unsuccessful procedure, injury to healthy tissue, infection, and infertility.³

Just because a procedure is common doesn’t mean it’s the right choice for everyone. Since UFE doesn’t target individual fibroids, outcomes might be harder to predict if you have multiple. If you hope to get pregnant, you should ask your doctor about how UFE might affect a future pregnancy.

What is radiofrequency ablation?

RFA is an outpatient procedure that delivers energy (targeted heat) to fibroids which softens and shrinks them, helping alleviate symptoms over time. The two types of this minimally invasive approach are the Acessa® and Sonata® procedures, which differ in the way your uterus and fibroids are accessed.

During the Acessa procedure, two small incisions are made in the abdomen so your doctor can access your uterus and target treatable fibroids with radiofrequency energy. It’s performed under general anesthesia and typically takes 1-2 hours, depending on the number and size of fibroids.⁴ Most women who have the Acessa procedure are cleared to go home the same day.⁵

Similar to UFE, the Acessa procedure is less invasive than major surgery, but recovery can come with side effects like, but not limited to, cramping, pelvic pain, urinary retention (the inability to fully empty the bladder) and urinary tract infection. Other risks associated with the Acessa procedure include the formation of scar tissue in the abdomen, vaginal bleeding, infection, internal injury, blood loss, and complications related to laparoscopic surgery and/or general anesthesia.

If you’re thinking about starting a family, talk with your doctor about your options. The Acessa procedure is not recommended for women who are planning future pregnancy, as the safety and effectiveness of the Acessa procedure with regard to fertility has not been established.

The Sonata procedure is an incisionless option that often takes less than an hour.⁶ During the procedure, a small device is inserted through your vagina and cervix into your uterus to direct radiofrequency energy to the fibroid. Patients treated reported fast recovery, and many returned to normal activities the next day.⁷

As with any surgical procedure, there are side effects of the Sonata procedure which include spotting, cramping, and discharge. Potential risks of the Sonata procedure are skin burns and infection. Be sure to ask your doctor to discuss the risks, benefits, and side effects of the Sonata procedure if you think it might be right for you.

The safety and effectiveness of pregnancy after the Sonata procedure has not been established, though some women have gone on to become pregnant after the Sonata procedure. If you’re thinking about starting a family, it’s important to talk with your doctor about your pregnancy goals before the Sonata procedure.