The timing of natural menopause after uterine fibroid embolization: a prospective cohort study

ObjectiveTo determine whether uterine fibroid embolization before the age of 45 years advances the timing of natural menopause.DesignProspective cohort study.SettingUniversity tertiary-care center.Participant(s)Forty-three regularly cycling women aged 35–44 years who underwent embolization and 43 age-matched control subjects.Intervention(s)Annual assessments of menopausal status using prospectively recorded menstrual diaries and hormonal (serum FSH and E2) and ultrasound measures (ovarian volume and antral follicle count). Women were followed for 7 years or until they reached menopause.Main Outcome Measure(s)Age at menopause as computed by subtracting the date of birth from the exact date of the last menstrual period.Result(s)Over the study period, 9 patients (25%) and 12 control subjects (33%) became menopausal, 19 patients (53%) and 18 control subjects (50%) entered the menopausal transition (irregular cycles), and 8 patients (22%) and 6 control subjects (17%) continued to menstruate regularly. Mean menopausal age in the embolization group (48.94 ± 2.48 years) was not significantly different from that in the control group (49.52 ± 1.25 years). There was no significant difference of menopause occurrence between the groups. Longitudinal changes in hormonal and ultrasound measures were similar for the two groups.Conclusion(s)This long-term follow-up study found no evidence for fibroid embolization advancing the timing of menopause in women before the age of 45 years.