Endometrial Ablation & Menopause

Menopause refers to the time when a woman stops having menstrual periods and is no longer fertile. The two to eight years prior to menopause is called the perimenopausal period. Perimenopausal women often have many symptoms associated with menopause. One of these symptoms is heavy or irregular menstrual bleeding. This bleeding can be severe enough to cause anemia and lifestyle changes. An endometrial ablation is a procedure that eliminates or lessens the bleeding associated with menopause. An endometrial ablation is not done on a woman who is already past menopause.

Benefits

• In the past, hysterectomies were commonly done to eliminate the bleeding associated with perimenopause. A hysterectomy involves removal of the uterus or the uterus and ovaries. It is a painful procedure and entails a long recovery time. In 1979, endometrial ablation was developed. In many cases this procedure can take the place of a hysterectomy. Endometrial ablation destroys or removes the lining of the uterus. In most cases menstrual periods stop after an endometrial ablation is done. Some patients still have periods but experience less bleeding. An ablation has a quick recovery time, few side effects and a low incidence of complications. Most women need only a day or two of rest and can resume all normal activities within two weeks.

Methods

• There are six different methods commonly used for this procedure. None of them involve an incision or cutting. The six methods are freezing, radiofrequency, heated fluid, microwave energy and electrosurgery. Most doctors have a method that they prefer to use. An ablation is a short procedure and is done as outpatient surgery. Time in the recovery room is about two hours.

Risks

• Although the rate of complications is low, some risk is inherent. There is a risk of bleeding or infection with this procedure. Burns to the vaginal area or bowels can occur with some methods as well. During an ablation, fluid is used to expand the uterus. In some cases, the fluid has been absorbed into the bloodstream. Rarely, perforation of the uterus may occur.

Misconceptions

• An endometrial ablation removes only the endometrium, which is the thin lining of the uterus. The ovaries and uterus are left intact; no cutting is involved. The ovaries that produce hormones are untouched during this procedure, so they continue to function normally. An endometrial ablation does not cause menopause because it does not affect a woman's hormones in any way.

Considerations

• If heavy menstrual bleeding is causing health problems or impacting lifestyle, an endometrial ablation can be a safe and successful alternative to a hysterectomy with less recovery time. Over 600,000 endometrial ablations are done in the United States alone each year.