Endometrial Ablation for Heavy Menstrual Bleeding

Heavy Menstrual Bleeding is estimated to affect 1 out of every 5 women. Heavy menstrual bleeding can be disruptive to a woman’s life in many ways (causing her to miss work, social events, preventing participation in sports, exercise or other active lifestyle activity). Heavy menstrual bleeding can also cause extreme emotional distress and be very expensive based on the cost of menstrual protection products.

What Is Endometrial Ablation?

The endometrium is a thin lining of tissue that is attached to the uterus. Endometrial ablation is the process of removing this thin layer. This can drastically reduce the amount of menstrual bleeding in an appropriately chosen patient. Most patients have very little or no bleeding following endometrial ablation. This procedure is most often performed in the office which reduces expense and time requirements. Most patients can return to work the next day after office endometrial ablation. North Carolina OB/GYN and Midwifery offers office endometrial ablation done under the care of our gynecologists in conjunction with an anesthesiologist to ensure a comfortable and less stressful experience.

Who Can Undergo Endometrial Ablation?

A gynecologist at North Carolina OB/GYN and Midwifery will evaluate your medical condition before recommending this procedure. Women who are nearing menopause and are suffering from heavy bleeding may undergo endometrial ablation. It is also recommended for women who experience excessive bleeding that leads to anemia.

Note that the chances of becoming pregnant after this procedure are drastically lowered. Additionally, pregnancies after endometrial ablation have a much higher risk of complications. Because of this, endometrial ablation is not recommended for women who have future family plans.

Preparation

We will determine if endometrial ablation is the best option by conducting the following:

• Pregnancy test – The procedure is not recommended for pregnant women.
• Cancer screening – A small sample of the endometrium will be collected by inserting a thin tube. The sample will be tested for cancer.
• Uterus examination – The uterus will be examined by either using an ultrasound or a scope through hysteroscopy. This will determine which endometrial ablation procedure is ideal for the patient.
• IUD removal – For women with an IUD, the device will be removed as required for the endometrial ablation procedure.
• Thinning the endometrium – A thin uterine lining is ideal for an endometrial ablation procedure. Thinning of the endometrium can be accomplished through medication. There is also a dilation and curettage (D&C) procedure, where a special tool is used to remove tissue from the uterine lining.

We will also discuss your anesthesia options. Either local or general anesthesia may be chosen depending on a variety of factors.

Endometrial Ablation Treatment Options

The endometrium can be destroyed using a variety of methods, including freezing, heating using heated fluids, or heating with electric current. The ideal method for you will be chosen during your consultation.

These procedures are non-invasive and involve no scalpels or incisions. They are done under local anesthesia, meaning the targeted area is numbed to any pain. A tool called a hysteroscope is inserted into the uterus to allow the gynecologist to see the inside of the uterus. A camera may be attached to this tool.

Electrocautery through wire mesh or radio waves: The cervix is opened, and a wire loop is inserted. This loop is attached to the uterus lining. A precise electric current is then sent through the wire loop to destroy the endometrium. The gynecologist may also choose to send the electric current through the mesh using radio waves.

Microwave: During this procedure, microwave energy is sent to the uterus lining using a thin probe. This energy heats and destroys the lining.

Heated Fluid: Heated fluid can either be pumped into the uterus or inserted using a balloon catheter to destroy the endometrium. In the case of a balloon catheter, the balloon contains the heated liquid that is pumped into the uterus.

Freezing: Endometrial ablation can be conducted by freezing the endometrium using a probe that has been frozen to a specific temperature.

Recovery Process

The patient will be released once their condition has stabilized. They will need to arrange for a friend or family member to drive them home. The patient may experience some of the following symptoms:

• Cramps – The patient may experience period-like cramps for the first few days. Medication can help deal with the pain.
• Frequent urination – The patient will urinate more during the first day.
• Vaginal discharge – A light bleeding or pink discharge can be experienced for the first few weeks of recovery.
• Nausea – The patient may feel nauseous for a few days.

Endometrial Ablation Cost

The cost of the endometrial ablation treatment will depend on the chosen procedure. Anesthesia fees may affect the overall price.