Why Might I Need An Endometrial Ablation
You may decide to have endometrial ablation if you have heavy or longperiods. You may also have it for bleeding between periods . In some cases, the bleeding may be so heavy that itaffects your daily activities and causes a low blood count becauseof it.
Heavy bleeding is described as bleeding that requires changing sanitarypads or tampons every hour. Long periods are described as lasting longerthan 7 days.
Menstrual bleeding problems may be caused by hormone problems. This isespecially true for women nearing menopause or after menopause. Othercauses include abnormal tissues such as fibroids, polyps, or cancer of theendometrium or uterus.
Endometrial ablation lessens menstrual bleeding or stops it completely. Youmay not be able to get pregnant after endometrial ablation. This is becausethe endometrial lining, where the egg implants after being fertilized, hasbeen removed. Pregnancies that occur after an endometrial ablation are notnormal, therefore it is important to use a reliable form of birth control.You will still have your reproductive organs.
Your healthcare provider may have other reasons to suggest endometrialablation.
What Should I Know After My Endometrial Ablation
While results may vary, women typically experience much lighter menstrual flows your periods may end altogether.
Even though becoming pregnant is less likely after the procedure, it is important to use some form of birth control if you are sexually active. Becoming pregnant after the procedure can be high-risk for you and your baby and could result in miscarriage or an ectopic pregnancy .
The results of the procedure typically last a few years. Depending on your age, the procedure can last until menopause and you may not bleed again. However, if bleeding increases, more definitive treatments such as hysterectomy may be evaluated with your provider.
Treatment Options For Women With Heavy Periods
There are a variety of treatment options for women with heavy bleeding. Combined have been used for decades to control heavy periods. The pill is frequently effective, but many women have concerns about side effects and consequences of long-term exposure to these hormones. Moreover, oral contraceptives are not be safe for many women: Women over 35 who smoke, or women who are very overweight, have high blood pressure, or diabetes are not ideal candidates for the pill.
A progesterone-containing intrauterine device is also sometimes used for control of heavy periods. The levonorgestrel-containing Mirena, for example, is easily placed during an office visit. For the first 3 to 6 months with Mirena, many women will report some disorganized bleeding usually this consists of periods which are a bit prolongedbut not heavyor persistent light staining between periods After 3 to 6 months, women with Mirena generally fall into one of two groups: Either they get light regular periods, or they get no periods at all. Some women are uncomfortable with the idea of a foreign body inside their uterus, and others are concerned about the small amount of hormones contained in the Mirena device. It does, however, provide an effective control of heavy periods in some women.
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How Can You Tell
And I know, you know, it’s a huge gap, when on Earth are you going to know when you’re starting the menopause when you’ve got no periods to give a really clear indication of what’s going on? In this situation, it really is a question of being aware of how you are feeling.
Are you starting to get menopause-like symptoms like hot flushes or night sweat? Or maybe joint aches or low mood or anxiety or maybe a bit of fatigue, or you’re just feeling out of sorts? If you’re in the average age group, then it’s more than likely that this is you starting the approach to the menopause.
What Are The Risks Of The Procedure
Major complications are rare, but because the procedure uses heat to destroy the lining of the uterus, the uterus can be thinned and surrounding organs such as the bladder, bowel, and vagina are put at a very low risk of complications from the heat.
A benefit of endometrial ablation is that the treatment can last until menopause and allow women to avoid the need for daily medication. However, about 20 percent of women require some kind of treatment afterward, such as a repeat ablation or a hysterectomy so the surgery isnt perfect. The reason for these additional treatments typically is that uterine tissue was not completely destroyed during surgery.
I see some women in their 20s who tell me they dont want babies and they hate their periods and want them to go away. I understand that however, this isnt always a good option for women so young because their bodies will still experience a hormonal response for 20 years or longer before menopause. With functioning ovaries, their body will try to create new life during each ovulation cycle. This process can cause tiny areas of uterine lining tissue to try to grow back. The longer a woman is exposed to that, the higher the risk that her uterine lining will grow back. In general, women who are younger than 45 years old at the time of ablation are more likely to need an additional treatment such as hysterectomy in the future.
How Is Endometrial Ablation Done
The nerves in your uterus cannot feel heat, cold, or electrical stimulation endometrial ablation is usually performed using one of these technologies. You may have cramping or other discomfort after the procedure, but most women dont feel pain associated with the procedure itself. Several weeks before the procedure, your doctor may give you medications that thin the lining of the uterus. The doctor may give you other medications the night before the endometrial ablation. These medications will make it easier to insert the devices used for the procedure into the uterus. There are several types of endometrial ablation, including electrosurgery, balloon ablation, bipolar radiofrequency ablation, and cryoablation.
- Electrosurgery: This type of endometrial ablation is performed in a hospital operating room. During the procedure, your doctor will either put you to sleep or give you medications through your veins to make you unaware of the procedure and/or to reduce any discomfort that you may experience. Using a special telescope, called a hysteroscope, the doctor will examine the inside of your uterus. Then the doctor will use a tool called a rollerball or other instruments that have electrical current to destroy the endometrium.
The following types of endometrial ablation surgeries are often performed in the hospital operating room, but can also be done in your doctors office:
What Are The Treatment Options For Postmenopausal Bleeding
The treatment offered will depend on the cause of the bleeding. For those with polyps, removal of the growths will need to be carried out by a specialist. Our Consultants are experts in removing those polyps under local anaesthetic.
Depending on the severity and type of endometrial hyperplasia, patients will either require hormone medications or a hysterectomy.
There are many different vaginal atrophy treatment options, including topical oestrogen, hormone replacement therapy and new, laser treatment therapies. If HRT is causing the bleeding, your GP may recommend you change your treatment or stop altogether.
Patients who have been tested and diagnosed with a sexually transmitted infection will be given antibiotics or other medications depending on the type of infection.
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Primary Investigation Of Ablation And Endometrial Cancer Rates
A total of 604 cases of endometrial cancer were identified, three in women who underwent ablations, and 601 in women who underwent medical management. This corresponds with a study-specific annual endometrial cancer incidence rate of 59.6/100,000 women, 19.3/100,000 in women who underwent ablations, and 60.3/100,000 in women who underwent medical management.
No increased risk was seen from ablation versus any medical management in unadjusted Cox modeling . In creating a multivariable model, among the 26 tested variables , only age was found as a confounder. Age-adjusted results also showed no difference between groups .
Kaplan-Meier curve for time to endometrial cancer
Legend. Abbreviations: CI, confidence interval EmCa, endometrial cancer. There was no statistically significant difference in hazards . The number of subjects indicates the number of subjects present at the beginning of each indicated year. Of note, the as-treated analysis allows a woman to switch from the medical management group to the ablation group.
Is There A Risk Of Worsening Endometriosis By Taking Hrt After Having An Oophorectomy Or Taking Medications To Cause Menopause
There is a theory that HRT contains just enough hormone to keep your bones healthy and to help with menopause symptoms and contains a low enough dose to not have an effect on endometriosis. This is called the estrogen threshold theory.
This means that it is rare for endometriosis to recur or get worse when on HRT but it is possible. It is more likely if there is a residual endometriosis and your HRT only contains estrogen.
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What Happens During Endometrial Ablation
Prior to endometrial ablation, an in-depth exam will be performed to ensure a thick endometrium is the underlying cause of bleeding and rule out other possible causes. The treatment itself is performed on an outpatient basis, usually under sedation. Ablation used to be performed with curettage, a technique that uses a special instrument to scrape away the uterine lining. But today, there are many other methods for performing endometrial ablation, including:
- Cryoablation: Using extremely cold temperatures to freeze the lining and destroy the tissue
- Radiofrequency: Using radio energy to vaporize the lining
- Hot saline fluid or a balloon filled with superheated liquid to destroy the tissue
- Microwave energy or electrocautery to burn the lining off
Once the endometrium has been removed from the uterus, scar tissue will form that will help prevent the tissue layer from reforming. Most procedures take about 30 to 45 minutes to perform.
How Long Is This Going To Last
Now, I then get asked, âWell, how long is this going to last?â On average, from the minute your hormones start to change until you would have been two years without a period when you are considered through the menopause, is roughly about five years. So if youâre in this situation, you would have a normal menopause lasting the normal length of time as well.
So from the moment that you start to see any significant changes, youâre going to be counting roughly five years, and that would be you postmenopausal. Again, itâs one of these things. Itâs going to be different for absolutely every single one of you.
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For Ablations Using A Hysteroscope
How Long Does It Take For Endometrial Ablation At Mayo Clinic
Depending on the type of balloon device, the procedure can take from two to 10 minutes. Microwave. A slender wand is inserted through the cervix. The wand emits microwaves, which heat the endometrial tissue. Treatment usually lasts three to five minutes. Radiofrequency. A special instrument unfurls a flexible ablation device inside the uterus.
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Can You Still Get Pregnant After Novasure Procedure
Pregnancy is not likely after ablation, but it can happen. If it does, the risks of miscarriage and other problems are greatly increased. If a woman still wants to become pregnant, she should not have this procedure. Women who have endometrial ablation should use birth control until after menopause.
Risk Factors For Endometrial Cancer
- Chronic anovulation
- Early age at menarche and late age at menopause
- Older age
- Low levels of physical activity
- Estrogen secreting tumors of the ovary
- Insulin resistance and type 2 diabetes
- Personal prior history of epithelial cancers of breast or ovary
- Family history of endometrial or epithelial cancers of the colon, breast, or ovary
- Unopposed estrogen or certain SERM use
- History of endometrial hyperplasia
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Umwhat A Permanently Scarred Uterus
I first heard about this months ago at a dinner party. I overheard a woman talking about a friend of a friend who had this procedure done. Normally, when I am part of conversations about health and wellness that I don’t fully agree with , I either zone out, smile and nod or walk away and find another conversation to be a part of. Everyone is entitled to their opinions and what they think is best for themselves and their families. Getting into debates isn’t generally appropriate in most circumstances.
However, when this person mentioned ablation, it was the first I had ever heard about it. I basically spit out my wine and said That is the most ridiculous thing I have ever heard.’...OUT LOUD. It was one of those moments where you think you said something in your mind but, nope, you didn’t and you can almost see the words in a talk bubble floating in the air. Oops!
I let it go at that thinking maybe this person had some sort of extreme circumstance, some rare experience that required ablation to be performed. None of my business.
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Why Treat The Symptom Not The Cause
This prodcure seems to me to be one more example of our medical system treating a symptom and not getting to the root of the issuethe actual cause of the heavy periods. From what I understand, periods get heavy and clotty for a variety of reasons, usually hormonal in nature. If the uterine lining is destroyed, the periods are gone but did the reason for the heavy periods get addressed? Of course not.
I think there have to be repercussions down the road from this procedure. The body is always striving toward balance and this procedure doesn’t seem to be helping in that matter. I know it is deemed safe’ now but I am really curious to see what happens in 20 years.
This procedure seems incredibly short sighted. Not getting at the root of the changes that occur during premenopause, or that may be going on at other times in a woman’s life for a variety of reasons.
What Happens During An Endometrial Ablation
You may have an endometrial ablation in your healthcare provider’s office,as an outpatient, or during a hospital stay. The way the test is done mayvary depending on your condition and your healthcare provider’s practices.
The type of anesthesia will depend on the procedure being done. It may bedone while you are asleep under general anesthesia. Or it may be done whileyou are awake under spinal or epidural anesthesia. If spinal or epiduralanesthesia is used, you will have no feeling from your waist down. Theanesthesiologist will watch your heart rate, blood pressure, breathing, andblood oxygen level during the procedure.
Generally, an endometrial ablation follows this process:
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What Is My Recovery Time After Endometrial Ablation
With endometrial ablation, recovery time is typically minimal, and most women who have undergone the procedure are up and around within a day or two. Cramping and vaginal discharge may be present while you heal for about 2 weeks. Cramping can be relieved with over the counter Ibuprofen for the first few days after the procedure.
Is There A Test That Can Help
One of the things that you can do is that you can go and ask your doctor for a hormone test. Now, the further through the menopause you go, the more accurate this test is going to be. But if your hormones have just started to change, then very often the test can come back negative purely because your hormones have been a little bit high on that particular day, and therefore you will think that you’re not in the menopause.
So, if you think to yourself, “I’m sure I’m starting the menopause. I’m getting some of the usual symptoms,” but the test comes back negative, then just go again in six months and ask to be retested. And you might find things have changed at that particular point.
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