To a great extent human use fo the landscape in (say) Europe has become much more productive since Mediaeval times because it became more intensive, not more extensive. True, the Cistercians are famous for having (grown extremely wealthy by having) brought unexploited land into use on a considerable scale. But on the other hand there is a landscape historian in Britain who makes a case (I'm not entirely convinced, but I'm not an agricultural economist, so I'm not really qualified to judge) that all or nearly all the land in use in England in 1930 was in use at teh time of Domesday Book (1078, IIRC).
Sure, there were forests in mediaeval England, but they were planted to grow timber, regularly logged, and fenced to keep the deer in, and pigs were masted in them. There were woods, but they were coppiced to grow wood for fuel and charcoal….
Things were no doubt different in other parts of Europe, for example in Prussia and Poland where the Deutschritters and other nobles brought in immigrant peasants to clear the forests in vast migrations that lasted two centuries. And there is nothing to say that a fantasy setting need be like England, France, or Italy rather than like, say, Lithuania. Just don't leap the the conclusion that mediaeval settings were covered in wilderness. It ain't necessarily so.