Treating Abnormal Uterine Bleeding with Endometrial Ablation

Are your periods interfering with your life?

A woman suffering from abdominal pain or cramps.
A woman suffering from abdominal pain or cramps. Marcela Barsse/Getty Images

If your menstrual periods are very heavy and interfere with your daily life, or you experience heavy uterine bleeding between periods, you may want to consider endometrial ablation, a procedure to stop or decrease your uterine bleeding. Here's what to consider before talking with your doctor about endometrial ablation.

What is Endometrial Ablation?

Endometrial ablation is a procedure designed to either stop or decrease your uterine bleeding.

It involves removing the endometrium, a thin layer of tissue lining the uterus, through a variety of means including the use of electricity, fluids, balloon therapy, high-energy radio waves, cold or microwaves.

What Classifies as Abnormal Uterine Bleeding?

While many women may think their periods are abnormally heavy, you should not undergo endometrial ablation unless your bleeding is truly abnormal. The major reasons for undergoing the procedure include:

  • Menorrhagia: Regular monthly uterine bleeding that is extremely heavy and can last anywhere from five to 10 days. Women with menorrhagia may become anemic from their bleeding and may miss many days of work per month.
  • Metrorrhagia: Heavy bleeding on an irregular basis. Bleeding often occurs every two weeks or is constant and heavy in nature. Women with metrorrhagia are typically anemic and will often complain of not being able to participate in life events because of the heavy bleeding they experience.

    Do I Qualify for Endometrial Ablation?

    If you experience any of the symptoms below, talk to your doctor find out if you qualify:

    • Your monthly flow is causing you a decrease in your quality of life.
    • Your menses are so heavy as to either cause anemia or interfere with your daily routines.
    • You are using new tampons or pads on an hourly basis.
    • Your periods are causing you anxiety, PMS or some other types of pain.

    Depending on your physician and your insurance, if you qualify for the procedure, you can elect for an office or outpatient setting. The procedure will be performed in the same manner in either setting, but the just the route of anesthesia will differ.

    When to Avoid Endometrial Ablation

    You'll want to avoid the procedure if any of the following apply to you:

    You are pregnant or hope to become pregnant. Endometrial ablation can compromise fertility.

    You don't know the cause of your bleeding. Women with undiagnosed uterine bleeding should undergo a biopsy of the lining and pelvic ultrasound in their doctor's office before the procedure. If you are diagnosed with cancer of the endometrium or a precancerous lesion like hyperplasia, endometrial ablation is not advisable.

    You've had a C-section. Women who have had previous uterine surgery, such as a classical cesarean or previous removal of a large fibroid or leiomyoma, tend to have a weakened uterus and may have more risk for a perforation during the procedure.

    Your uterus is very small. Your doctor can determine if your uterine cavity is too small for the device used to perform the procedure.

    You have an IUD. Intrauterine devices (IUDs), are inserted into the uterus to prevent pregnancy, and will get in the way of the procedure.

    You have a uterine infection. Existing infections will make the procedure unsafe, and women should wait until an infection has healed before undergoing endometrial ablation.

    The Bottom Line

    You do not have to live with heavy menstrual bleeding. If you are finished having children, talk with your physician about your options and see if an endometrial ablation may be right for you. While the procedure is not 100-percent guaranteed, in most women, it can decrease the blood flow to simple spotting in one to two days and get you back to living your life. As with any surgical procedure there are inherent risks you should discuss with your physician before you make and educated plan on your healthcare.

    Sources:

    John Hopkins Medicine Health Library. Endometrial Ablation.

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