Menorrhagia, or excessive menstrual bleeding, occurs in one out of five women. These women bleed enough to soak through a pad or tampon every hour on their heaviest days or suffer from anemia due to excessive blood loss.
Medication is typically the first prescribed treatment for heavy bleeding but another option is endometrial ablation. Endometrial ablation destroys the endometrium or the lining of your uterus.
There are six enodometrial ablation procedures.
Electrosurgery uses a fiber-optic scope to see inside the uterus. The scope’s tip becomes hot and carves grooves into the endometrium. This can take 10 minutes.
Cryoablation uses extreme cold to create ice balls that freeze and destroy the endometrium. This takes 10 to 20 minutes.
Hot saline fluid is circulated within the uterus for about 10 minutes. This method can be painful, but it achieves complete coverage.
Another is a balloon device inserted through the cervix and then inflated with hot fluid. The balloon helps prevent fluid from escaping up the fallopian tubes. This takes about 30 minutes.
In the microwave method, a thin wand emits microwaves, which raises the temperature of the endometrial tissue. The wand is moved from side to side while pulling it out of the uterus. This usually takes one to four minutes.
Radio frequency uses an instrument inside the uterus to transmit radio frequency energy which vaporizes the endometrial tissue within 80 to 90 seconds.
The procedures use general, local or spinal anesthesia and leave no incisions. Endometrial ablation can be done in an outpatient facility or operating room. Recovery time is typically two hours.
Afterward, patients may experience menstrual-like cramps for a few days. A watery vaginal discharge, mixed with blood, may occur for a few weeks. Frequent urination is also possible during the first 24 hours. Some women also have feelings of nausea.
It may take a few months, but endometrial ablation usually reduces menstrual bleeding. Most women have lighter periods and up to half stop having them entirely.
Pregnancy is still possible. However, they usually end in miscarriage because the lining of the uterus has been damaged.
Endometrial ablation risks include accidental puncture of the uterus, burns to the uterus or the surface of the bowel, buildup of fluid in the lungs, sudden blockage of arterial blood flow within the lung, or tearing of the opening of the uterus. These are uncommon but can be severe.
Endometrial ablation isn’t recommended for women who wish to become pregnant in the future; have significant menstrual cramping; have cancer of the uterus; were recently pregnant or are past menopause.