Below is an article from the Reno Gazette Journal (my old hometown!) I am including it here because it is one of the few I have found that explains endometrial ablation in simple terms. This is a procedure, according to this article, that can be performed in the doctor’s office. No hospital stay, no weeks of recovery, no scar, no surgically induced menopause, no additional risk of hormone imbalances leading to osteoporosis or depression or, or, or…. This procedure is not suitable for all uterine problems but if you suffer from extremely heavy and/or painful periods, this might be the procedure for you. Ask your doctor.
Slowing the menstrual flow
‘NEILL
MONEILL@RGJ.COM
December 18, 2007
A 90-second surgery changed Lori Mays’ life. After surgery, Mays, of Reno, had a newfound freedom.From her menstrual period.
The 44-year-old no longer needed to slip out to the bathroom to change sanitary supplies. She didn’t have to stock her purse with tampons and pads. And she could let go of all the worries associated with a heavy period, such as leaking, as she wasn’t having a period anymore.
With a minor surgical procedure called endometrial ablation, performed by a doctor, her periods stopped. The procedure her doctor uses vaporizes the lining of the uterus.
It is not a choice for a woman wanting to conceive. But that wasn’t a problem for Mays, who was past the child-rearing stage.
“I went to the bathroom all the time,” she said. “And for people you work with they kind of know why are you going in there.”
Mays’ doctor, Hilton Pollock, of Reno, uses a machine to perform endometrial ablation that is marketed as NovaSure. Variations on the endometrial ablation surgery exist, but he only uses the NovaSure process.
“Until something new comes on board, this is the best procedure for women (with heavy periods) in this country at this time,” Pollock said.
In the NovaSure process, a thin wand is inserted into a woman’s uterus and radio frequency waves vaporize the lining. NovaSure has a 97 percent success rate in reducing bleeding from heavy periods, he said. The process takes less than two minutes and requires about 45 minutes in a doctor’s office. Most insurances, Pollock said, charge the cost of an office co-pay for the procedure. Mays, an office manager for a geotechnical engineering firm, said she paid $10. Recovery from the procedure is quick. Mays went back to work that day.
Getting heavy
According to a study by the National Women’s Health Resource Center, heavy periods can affect women in their professional and personal lives. Some women will stay indoors. Others will avoid people to relieve worry. Mays’s periods were heavy for seven days straight. Accompanying her periods were unpleasant cramps.
“Cramping was bad all the time,” she said. “I dealt with it. It was part of life.”
Heavy or long periods are called menorrhagia in the medical world. One in five women in the United States suffers from heavy periods.
Before using any procedures to treat heavy bleeding, a doctor should first do hormone tests, check the thyroid, check for anemia and check for polyps or uterine cancer.
Clots can be an indication that a woman indeed suffers from heavy bleeding and not something else.
“Normally, blood clots are reduced to liquid flow,” Pollock said. “When the bleeding is too heavy, clots are formed and they are not reduced to liquid flow.”
Two-thirds of women Pollock has treated using NovaSure have completely stopped menstrual bleeding. Contraception has to be used after the surgery, as a women’s eggs are not affected.
Other options
Endometrial ablation is not the only treatment for heavy bleeding.
“You would not want to do that with someone who still wants to maintain fertility,” said Cheryl Hug-English, director of student health services at the University of Nevada, Reno.
Other options to endometrial ablation include hormone treatment, intrauterine devices, dilation and curettage and hysterectomy. The latter, removal of the uterus, is a major surgery that can take several days for recovery.
Birth control pills will typically make periods come on a more regular basis and be less severe, said Hug-English.
Many types of hormone therapy, such as the pill, are now being marketed for the ability to suppress periods. One pill, called Lybrel, is taken continuously throughout the year and women have no periods. But Hug-English said most makers recommend allowing the period to come every three months.
She said that for young women with heavy periods, birth control pills are the best option.
“They are certainly the most common,” she said. “They are well-tolerated and heavy periods respond well to them.”
The intrauterine device, or IUD, can also be used.
“IUDs are not the best choice for heavy periods,” Hug-English said. “Sometimes they can do the opposite and cause heavier flow and more cramping. Just the fact that you have a foreign body in the endometrial lining can trigger heavy periods and then cramping.”
But about one-third of the IUDs that Pollock uses with his patients are for treatment of heavy bleeding. An IUD can reduce blood flow up to 85 percent, he said.
Dilation and curettage, another option, is a short-term solution for heavy bleeding. In dilation and curettage, the top layer of the uterus is scraped.
The effects are not long-lasting and heavy bleeding usually returns. Whatever the decision, a woman should talk to her doctor about her heavy bleeding. This can be difficult as one study has shown that women are reluctant to bring up the topic.
For Pollock, the NovaSure process is one way to help his female patients.
“It really has empowered women to control their bleeding issues with minimal costs and minimal complications,” he said.
