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Endometrial Ablation | Dallas

Updated on December 15, 2009

It is no secret that the menstrual period can be an extremely difficult time for any woman to deal with. One of the biggest frustrations can be the bleeding that comes with menstruation as the uterus sheds a layer of endometrium that has built up since the previous cycle. In certain situations, heavy menstrual bleeding can occur that lasts longer than normal, which further adds to the difficulty of going through menstruation. This condition, known as menorrhagia, can be treated with a relatively simple in-office procedure known as endometrial ablation. 

Menorrhagia

In the female anatomy, the inner wall of the uterus is lined with a substance known as endometrium. During menstruation, the endometrium gradually thickens and is shed in the form of bleeding. In certain conditions, such as menorrhagia, this bleeding can be abnormally heavy. Additionally, certain conditions affecting the endometrial lining can cause irregular periods. In situations such as these, a common treatment is to remove the endometrium through endometrial ablation. Another more invasive option is the complete removal of the uterus with a hysterectomy procedure.

Endometrial Ablation Overview

Endometrial ablation is the procedure in which the endometrium that lines the uterus is removed. The procedure is most commonly performed as an outpatient treatment with a minimal recovery time and is a good alternative to a regular hysterectomy in the treatment of heavy menstrual bleeding.

According to OB/GYN Dr. Dennis Eisenberg, affiliated with Baylor Medical Center of Plano, “Women with heavy menstrual bleeding, which is referred to as menorrhagia, are often treated with endometrial ablation to improve their quality of life. Additionally, the procedure is used as an elective procedure for women who have already had children or do not want children, but would like to stop having heavy period.”

Procedures

Endometrial ablation procedures have been used for years to treat irregular bleeding. There are a wide variety of methods for the procedure. Originally, an endometrial ablation was performed through the use of a hysteroscope, a tiny camera used to look into the uterine cavity through the vagina. An instrument would be used to “shave” the uterine wall or a roller electrode would cauterize or burn the inner wall of the uterus, similar to a paint roller on a wall. Newer methods of treatment enable a greater coverage area during the endometrial ablation and reduce both the invasiveness of the procedure and the time it takes to complete.

The balloon method can be accomplished in two ways. In the first type of balloon endometrial ablation, the balloon is inserted in the uterus and filled with fluid, which is heated to remove the endometrium. In the second type of balloon treatment, the balloon has a surface covered with electrodes. A current is run over the surface of the balloon to remove the endometrium.

Another method for endometrial ablation is through the use of microwave technology. A small rod is inserted in the uterus through the vagina and microwave energy is run through the end of the rod, which is swept back and forth across the inner wall of the uterus to remove endometrium. Other methods rely on freezing or laser technology in the removal of endometrium.

Novasure

Finally, the Novasure ablation provides another option for the treatment of heavy menstrual bleeding. The Novasure ablation is an endometrial ablation system that treats the entire inner wall of the uterus at one time. This is accomplished through the insertion of a skinny metal sheath into the uterus through the vagina. Once the sheath is inserted, a mesh screen is released to cover the entire inner wall of the uterus. An electric current is run through the mesh screen that burns off the endometrium.

According to Dr. Eisenberg, “I use the Novasure ablation system in my office. With the Novasure ablation system, I am able to get up to 95% coverage of the uterus. The process usually takes about a minute and the patient cannot feel anything while the procedure being done.” The procedure is performed under anesthesia provided by an anesthesiologist.

Risks

While any medical procedure has a risk of complications, the level of risk for complications from an endometrial ablation procedure is relatively low. These complications include perforation to the uterus, burning of the uterine wall, pulmonary edema, pulmonary embolism, and cervical laceration. While the risk for these conditions is extremely low, if any complications were to occur they could be quite severe.

Recovery and Coverage

When considering treatment for menorrhagia, there are a number of options for treatment. Heavy menstrual bleeding can be treated with hormone therapy, a hysterectomy procedure, one of the newer birth control pills, or with an endometrial ablation. Of these treatments, endometrial ablation is the quickest method of treatment, and often the most effective of the conservative treatments. Recovery times for the procedure range from 24-48 hours in most cases.

Additionally, most insurance providers offer coverage for endometrial ablation in the treatment of menorrhagia. Coverage is usually verified before the procedure by the doctor’s office.

Conclusion

Ultimately, there is hope for women suffering from heavy menstrual bleeding. Endometrial ablation offers women the chance to receive treatment that will not interrupt their day-to-day life to a high degree. According to Dr. Eisenberg, “While there are a number of treatments available for menorraghia, modern advances have allowed for women to receive timely treatment for their condition without requiring a long, uncomfortable recovery time.”

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    • profile image

      Musbdeby 

      3 years ago

      I had the Novasure done 5 years ago and it has been great. No cycle since I walked out of the doctors office. I have had back pain and lower stomach pain, as well as frequent yeast infections and lastly a strange smell from the vagina. After much research I have found this to be common with other who have had the Novasure procedure. I truly enjoy no cycle being that I am 50 years old, but the minor pain, yeast infections (always following sex) and smell is something I would have considered if they would have told me this before. My cycle was sort of heavy and unpredictable, but I think I would rather have that than this.

    • Bedbugabscond profile image

      Melody Trent 

      6 years ago from United States

      I had an endometrial ablation over a year ago and it was the best thing that ever happened to me. Meredith, many insurance companies will only approve the procedure if you have, or get, your tubes tied. This is because it mostly prevents pregnancy, but if you do get pregnant it could be dangerous.

    • profile image

      Meredith 

      7 years ago

      This procedure not only gets rid of your period, but it eliminates your ability to have children. I like what I am reading. Is this so bad? I am a young teen myself, but I am thinking, that if in four years time (I am fourteen at the moment) I still have the same want for this, I think I will follow through. Of course I'll look into it further, and the complications are pretty nasty, but I'm sure that as soon as I'm well informed, I'll be able to make an intelligent decision.

    • profile image

      Cynthia 

      7 years ago

      Having an ablation was one of the best things that I have done! Sorry to those of you that had complications, but that is the minority. Many people, myself included have had excellent results. I was bleeding through a "super plus" tampon, a pad, and onto my shorts within an hour before I had the procedure done! Now I have a light period. It saved me from years of misery (as I was 22 at the time) and kept me from having a hysterectomy and having to deal with the issues that come along with that. If you pick a doctor that knows what they are doing there shouldn't be any problems.

    • profile image

      Ashley 

      8 years ago

      I had the EA, Novasure done in 2006. Everything went smoothly and I have not had a period since the procedure. which is PERFECT! : ) now I am no longer wanting to have sexual activities and am afraid this is natures way of saying...I don't need to perform "that" due to the fact that I can no longer have kids. anyone else having this problem?

    • profile image

      notsure 

      8 years ago

      I had the novasure performed today or at least dr. attempted and perforated my uterus and now i seem to be swelling up in my abdominal area. Not a lot of pain but crampy. my doc said see u in 2wks and we will try again in 6wks. I am not sure i want to try again after reading all the complications. I have not read anyone who has had a 2nd ablation post perforation.

    • profile image

      Cindy 

      8 years ago

      I had EA done in February. It is by far the worst decision I have ever made in my life! The doctor ended up perferating my uterus and this "easy 20 minute procedure" lasted 2 1/2 hours. The doctor had to open me up and suck out all of the saline solution she had injected in my uterus. During the surgery I had to be intubated, and I began to bleed profusely and the doctor could not get the bleeding to stop. They say the risks are low, but I ended up being one of the "lucky" people who ended up with a saddle pulmonary embolism and almost died. I would not recommend this procedure to ANYONE. It's not worth dying for!!!

    • Mizsnow profile image

      Mizsnow 

      8 years ago

      I had this done in 2008. Worst Thing I ever did. I have been fighting for almost 3 years now to regain me life... I say to any women considering this please do your reseach.

    • allshookup profile image

      allshookup 

      9 years ago from The South, United States

      I had EA. It will be 2 years this coming Valentine's Day. Yes, a very romantic thing to do on that day lol. I am on high dosages of Coumadin, so you can see why I would need it done. This is the first hub I've seen on this subject. I'm glad you did it. I had it done in Memphis, TN.

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