After a fibroid diagnosis, you may be choosing between Uterine Fibroid Embolization (UFE) vs hysterectomy as treatment options. One of the concerns for women considering these options is the effect of treatment on sexual health. In this post, we review studies on how UFE and  hysterectomy affect sexual life.

Key Takeaways

• Uterine fibroids are non-cancerous tumors
• You can shrink the tumors with Uterine Fibroid Embolization, remove them individually via surgical myomectomy, or remove the uterus via hysterectomy
• When considering options, women should be aware that hysterectomy can result in sexual dysfunction, while UFE tends to improve sexual health

UFE vs Myomectomy or Hysterectomy: Factors to Consider

When choosing between fibroid treatment options, efficacy rates are naturally a prime consideration. Studies comparing UFE vs myomectomy reveal similar rates of efficacy, with UFE offering the advantage of an easier, post-procedure recovery. Now, hysterectomy is the only treatment option that ‘cures’ fibroids—once you remove the uterus, uterine tumors can’t regrow. However, as a major surgery, undergoing a hysterectomy can result in several unwanted side effects. And one of those effects is reduced sexual dysfunction.

How does a Hysterectomy Affect Sexual Life?

According to this study, many women experience improved sexual function after undergoing a hysterectomy for uterine fibroids. But that’s not true for everyone. In fact, the study reveals that between 10 and 20% of women noted that their sex life worsened after their hysterectomy.

For those women, post-hysterectomy sexual problems include:

• Difficulties with arousal
• Reduced desire,
• Pain during sex
• Changes to their orgasm

Who’s at Risk?

Certain groups of women were more likely to experience problems with sex after their hysterectomy. Those included women who’d previously experienced sexual concerns, those with a history of depression, or those with endometriosis. Yet study authors noted the complications could also have physical causes. These included:

• Formation of vaginal scar tissue preventing expansion with arousal
• Reduced blood flow due to tissue removal could limit genital swelling with arousal
• Nerve damage could reduce arousal or even cause pain during sex
• Inability to experience uterine contractions could reduce orgasmic sensations

Sexual dysfunction was a not-uncommon concern after surgical removal of the uterus. But study authors noted that, when women also had their ovaries removed, the sudden hormonal drop also resulted in:

• Increased vaginal dryness
• Reduced sexual satisfaction
• More severe menopause symptoms
• Increased risk for heart disease over time

UFE vs Hysterectomy: Effects on Sexual Health

While the research on sexual dysfunction after hysterectomy is concerning, the outlook on your sex life after UFE is far more promising. In this 2017 French study called EFUZEN, researchers explored how UFE affected women’s sex life. Specifically, they wanted to know if this fibroid treatment improved function or made sex worse. Here’s what they found:

Of the 264 women who participated in the study, 78.8% reported improvements in their sex life one year after UFE.  And those improvements were noted across the board, in areas such as:

• Desire
• Arousal
• Lubrication
• Orgasm
• Satisfaction

They also noted dramatic reductions in pain during intercourse following treatment. These improvements in sexual function came along with other noted benefits, including:

• An improved quality of life for 92% of women
• Reduced symptom severity, especially when it came to pelvic pain and heavy bleeding

Best of all, women experienced these results regardless of how much tumor shrinkage could be seen on MRI following UFE. And, while 21% of women were not able to report improved sexual function after UFE, none of the women reported worse sexual function, compared to approximately 20% of women whose sexual function worsened after hysterectomy.

Clearly, in this comparison of UFE vs hysterectomy’s effects on sexual health, UFE was the winner: the majority of women experienced improvements in their sex life following embolization, with none experiencing worsened sexual function.

UFE vs Hysterectomy: Additional Data on Sexual Health

The Dutch EMMY trial showed similar results. In this 10-year, randomized trial, researchers found that women who treated fibroids with UFE reported a significant improvement in their sexual function. In contrast, the women who were treated via hysterectomy did not report improvements in their sex lives. Moreover, there was again a group of participants whose sex lives were worse following their surgery.

Now, UFE will not be the best treatment option for all women. However, it is important that you understand all potential treatment side effects before deciding between UFE vs hysterectomy.

Since Uterine Fibroid Embolization is a minimally invasive procedure, performed by an interventional radiologist, it allows for tumor shrinking without major incisions.  Women keep their uterus, avoid menopause, and seem to experience improved sexual function following their reduced recovery period. Additionally, many women go on to have children following embolization.

In contrast, women immediately enter menopause following a hysterectomy. While some women do experience improved sexual function after this procedure, up to 20% of women report that hysterectomy has a negative impact on their sex life. Additionally, studies suggest the surgery increases the long term risk for heart disease. And, because it requires major incisions, general anesthesia and overnight hospital stays, hysterectomy tends to be more expensive than UFE, and comes with a longer, more painful recovery period. (That extended recovery period can result in further financial losses, as you may need to take more time away from work following a hysterectomy.)

Choosing Your Best Fibroid Treatment Option

Counseling and a careful review of your medical history is important when choosing between UFE vs hysterectomy or any other fibroid treatment. But we strongly encourage women to explore their treatment options and avoid hysterectomy when possible, since this major surgery can result in a series of unwanted side effects, including the potential for decreased sexual function. To learn more about your options and explore your UFE candidacy, we encourage you to contact our team of interventional radiologists and request a consultation at one of our three locations in the greater Atlanta area.