Is Endometrial Ablation a Suitable Treatment for my Heavy Periods?

02 Jun Is Endometrial Ablation a Suitable Treatment for my Heavy Periods?

Endometrial ablation is a minimally invasive surgical procedure to treat heavy periods. It is highly effective with up to 90% of women having either very light periods or no periods at all after this procedure. It is an alternative to women wanting to avoid hormonal treatments such as hormone releasing intrauterine device or a hysterectomy.

A thin telescope (hysteroscope) is passed through the cervix and into the uterus. It is fitted with a light source and video camera to allow the surgeon to examine the internal lining of the uterus through a video monitor. First generation (using a resectoscope) or second generation devices (such as NovaSure) deliver energy inside the uterus, and destroy (ablate) the internal lining (endometrium) of the uterus. It is usually done under general anaesthetic as a day procedure, with no incision, and a 1-2 day recovery period. If permanent contraception such as tubal ligation (a laparoscopic procedure) is offered at the same time, recovery may take up to 1 week. Permanent contraception is recommended to prevent pregnancy in the abnormal ablated endometrium.

Endometrial ablation works best in uterus which is normal in shape and size, not enlarged due to adenomyosis or fibroids. It is also important to rule out any pre-cancerous or cancerous cells within the endometrium before it is ablated. Endometrial biopsy is typically taken at the time of the procedure, prior to the process of ablation. Women with increased risk of endometrial cancer, such as being overweight should avoid endometrial ablation. Endometrial ablation is also more likely to be unsuccessful in younger women.

As endometrial ablation involves irreversibly destroying the internal lining of the uterus, it is only suitable for women who have completed their family. In fact, pregnancy in previously ablated uterus is very dangerous to both the mother and baby. Permanent contraception such as tying or removing the fallopian tubes is typically done at the time of endometrial ablation. Vasectomy in partners is a suitable alternative. All surgery, including minimally invasive surgery such as endometrial ablation, presents risk. Suitability, pros and cons of endometrial ablation, and alternative treatment options of heavy periods need to be discussed with your gynaecologist.