Menopause and Menopausal Symptoms after Ovarian Artery Embolization: A Comparison with Uterine Artery Embolization Controls

Abstract

Purpose To determine the impact on menstrual status and menopausal symptoms of ovarian artery embolization (OAE) to supplement uterine embolization (UAE) for uterine leiomyomas. Materials and Methods A single-center case-control study was conducted in women who underwent UAE for leiomyomas. Between May 2004 and July 2009, 77 patients underwent unilateral or bilateral OAE during UAE procedures. Contemporaneous control subjects undergoing UAE alone were identified based on age and race. Questionnaires queried menstrual cycle regularity, onset of menopause, hormone use, and subsequent leiomyoma interventions, as well as the Menopause Rating Scale (MRS), a validated menopausal symptom questionnaire. Records were reviewed for baseline clinical and procedure data. Case and control subjects were compared for baseline characteristics and outcomes with the use of appropriate statistics, with the primary outcome the summary score on the MRS. Results Of 154 patients, 51 case subjects and 49 control subjects responded to the MRS (65%). Case subjects had greater tumor volumes (median, 129.3 cm 3 vs 69.3 cm 3 in control subjects; P = .0252) and longer fluoroscopy times (mean, 20.5 min vs 14 min in control subjects; P < .0001), with no other differences. There was a lower mean MRS score in the OAE group (total mean MRS score, 7.4 in case subjects and 8.9 in control subjects; P = .023), indicating fewer menopausal symptoms and no difference in menstrual regularity or frequency of onset of menopause. Of six patients who underwent bilateral OAE and responded, all reported continued menstrual cycles. Conclusions Compared with standard UAE, the addition of OAE does not appear to precipitate the onset of menopause nor increase menopausal symptom severity.