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Health IQ: Endometrial Ablation - - Archived

Are you finished having children? Is your regular visit from Aunt Flo ruining your vacations and your life? Would you rather avoid taking oral contraceptives to control your periods? If you answered yes to any of these questions, keep reading.

There is a way to reduce (or possibly even stop) heavy periods without having to remove any lady parts. It’s called endometrial ablation.

Endometrial ablation is a surgical procedure that destroys the endometrial lining (watery tissues) of the uterus. “The goal is to vaporize it all and have it scar down so that no more (or minimal) lining grows back,” said Kevin M. Audlin, MD, co-director of the Minimally Invasive Fellowship in the Division of Gynecology at Mercy Medical Center in Baltimore, MD. “Less lining less bleeding monthly.”

According to Gil Weiss, MD, assistant professor of Clinical Medicine at Northwestern Memorial Hospital and partner at The Association For Women’s Health Care, endometrial ablations may be performed in a physician’s office, an outpatient facility, or in a hospital operating room. The procedure involves inserting a device into the uterine cavity and using heat, electricity, or freezing to destroy the lining, he said. It takes less than 60 minutes, and patients can go home the same day. Cramping and vaginal discharge usually continue for up to two weeks.

Different endometrial ablation procedures have varying success rates. According to Dr. Audlin, NovaSure uses heat energy and has been known to completely stop periods in about 40 percent of patients. A newer method, Minerva, uses heat energy and water, and has successfully stopped periods in about 70 percent of women, he said. However, if success is strictly measured by a reduction in bleeding, then about 85 percent of women report being satisfied with their procedure. “The goal of the ablation should be decreased bleeding; complete stopping of bleeding is a bonus,” Dr. Audlin explained.

Women who definitely do not want a period any longer or have experienced a failed ablation might consider having their uterus removed. Sounds extreme, but it’s not as bad as you might think. “As long as you keep your ovaries, you aren’t in menopause so you won’t need hormones,” said Dr. Audlin. “You just won’t bleed.”

Pros & Cons

As with anything, there are pros and cons to consider.

Pros

  • Short procedure
  • Minimal pain
  • Quick return to work
  • No incisions
  • Cheaper than a hysterectomy
  • Very easy to perform and mostly controlled by computer

Cons

  • Not a guarantee to stop bleeding
  • Some patients have worse pain or may experience post-ablation syndrome
  • Some may experience regrowth of the endometrium
  • Accidental punctures in the uterus or abdomen could lead to complications

 

By LaRue V. Gillespie

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