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Here is some other information regarding endometrial ablation and hysterectomy that I found, and hope are helpful in your decision.

Ablation
I found an online brochure on endometrial ablation that explains the treatment and recovery of this procedure:
http://www.acog.org/publications/patient_education/bp134.cfm

Hysterectomy
You may find this study interesting by The American College of Obstetricians and Gynecologists (please note, it is from eight years ago):
http://www.greenjournal.org/cgi/content/full/95/2/199
[Source: Obstetrics & Gynecology 2000;95:199-205]

Summary of the above clinical study, "The Appropriateness of Recommendations for Hysterectomy":
- The most common reasons for hysterectomy are fibroids (leiomyomata), pelvic pain and excessive bleeding (menorrhagia)
- 70% of hysterectomies from the cases studied were "judged to be recommended inappropriately", due to not meeting AGOG criteria for hysterectomy or not trying other remedies first
- "...bleeding is just a symptom, not a disease, and you need to know the cause [of bleeding]..."

It sounds like in your case the cause of bleeding is from a hormonal imbalance. What type of hormonal imbalance has your doctor diagnosed?

According to the Health System at UVA, there are many possible causes of menorrhagia:
- hormonal imbalance
- pelvic inflammatory disease (PID)
- uterine fibroids
- abnormal pregnancy (i.e., miscarriage, ectopic)
- infection, tumors, or polyps in the pelvic cavity
- certain birth control devices (i.e., IUDs)
- bleeding or platelet disorders
- high levels of prostaglandins
- high levels of endothelins
- liver, kidney, or thyroid disease

Treatment Options for Non-Cancerous Uterine Conditions
http://www.ahrq.gov/research/uterine.htm
provides a chart for treatment alternatives, but is from over ten years ago...you may want to show your doctor the chart, and ask for the most recent source from the US Department of Health and Human Services (USDHHS) or American College of Obstetricians and Gynecologists (ACOG).

Summary of Chart (USDHHS, 1995)
- "Evidence regarding the effectiveness and relative effectiveness of hysterectomy and alternative treatments is seriously lacking"
- "For dysfunctional bleeding, compare the outcomes of alternative treatments, including medical treatments, surgical alternatives (endometrial ablation and hysterectomy), and watchful waiting."

Has your doctor talked with you about medical treatments, as it sounds like you already know about the surgical treatment options (ablation and hysterectomy), and you have probably opted out of, or have done, the "watchful waiting"

September 23, 2008 - 2:40pm

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