Why endometrial ablation may be the answer to heavy menstrual bleeding

A large responsibility of an MD like myself is to stay informed about available treatment options in order to best advise my patients and offer them the best possible level of care. However, there are still some procedures about which many professionals and patients alike do not know. One such procedure is endometrial ablation, which can be a very effective treatment for women who experience heavy menstrual bleeding.

I’ve been doing ablation procedures for over 24 years, and it still amazes me that not all family doctors and patients are aware of how effective this procedure can be for women who are candidates for it. While the technology has changed over the years to make it even safer and simpler, the procedure is not new. It has been used in over 2.5 million women around the world.

Heavy periods are common. In fact, more than one in three women (35-40%) over the age of 40 experience heavy menstrual bleeding, which undoubtedly takes its toll on their quality of life. It can cause anemia, tiredness and heavy fatigue, limiting women’s effectiveness at work, at home, and in their relationships. One patient was telling me that her job requires her to travel and heavy menstrual periods not only limit her wardrobe, but also cause her undue stress and anxiety while on the road, which also negatively impacts her work performance.

 

Endometrial ablation, an alternative to hormones and surgery

Believe it or not, in the “old days” it was very common for women to automatically get a hysterectomy after finishing having children. Endometrial ablation offers an effective alternative to such surgery.

Also, some women take birth control pills to reduce the symptoms of heavy periods and menstrual cramps. However, the last thing a woman in her forties wants is additional hormones in her body and so many women in this age group are looking for alternatives to hormone therapy such as taking the birth control pill.

While endometrial ablation is only available to women who are finished having children but who have not yet entered menopause (typically in their late thirties to forties), it is a procedure that candidates and their doctors should consider, if not for its simplicity and ease, then for its success rate. There have been many studies done and the research shows that 93% of patients who’ve had an ablation have been satisfied with it. Another 97% would recommend it to a friend.

 

A 90-second procedure, covered by MSP

Endometrial ablation is a short procedure, which involves the cauterizing of the lining of the uterus, a technique using radio frequency energy. It does not affect hormones or other parts of the uterus or ovaries.

It also lasts only 90 seconds and recovery is quick. The patient comes in and goes home the same day and while she might have some discomfort and cramps, these usually resolve within 12-24 hours on average. Many patients go back to work the next day, but on average patients will take 2 to 3 days off work.

Ablation is done under intravenous sedation with no general anaesthetic. An anesthesiologist is present throughout the procedure and makes sure that the patient is not experiencing any pain and is comfortable.

In conjunction with the procedure, the doctor will also take a biopsy (a sample of the lining of the uterus) as a cancer screening. This ensures we don’t miss any cancerous or precancerous tissue.

Women who are interested and think they are candidates should see their family doctor first to receive a referral for an appointment with me or another gynecologist, who will conduct a full consultation to to see if they’re a candidate. The consultation and procedure is fully covered by your BC Medical Services Plan (MSP).

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