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Your overview of heavy bleeding is good. However, the root cause is one of two things It could be hormonal; which can generally be treated with things like birth control,or pathological such as a fibroid, polyp, or a condition known as adenomyosis. If this is the cause or heaving bleeding then surgery is your best option. The best way to diagnose the root cause is a blood workup to rule out hormonal causes. Then, the next thing should be a saline infuse transvaginal ultrasound or a diagnostic hysteroscopy to see inside the uterus. Transvaginal ultrasound alone is known to miss intra-uterine pathology such as polyps or fiborids. As such, far too many women are misdiagnosed and perscribed birth control as a first line treatment only to fail. Women need to ask their doctors about their screening process. If they only do transvaginal ultrasound, there will be a high chance of missing fibroids. Additionally, if one has intracavity fibroids, it is best to remove them vs. doing a global endometrial ablation. If removed first, then followed by an ablation, one will likely have better outcomes. Simply removing the fiborid may be enough. I can personally speak about this as I recently went through a fibroid removal procedure that was fast and incisionless. It was called the Myosure procedure. To learn about it you can visit the companies website at www.myosure.com