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Heavy Periods: 5 Common Questions about Endometrial Ablation procedures

Heavy Periods: 5  Common Questions about Endometrial Ablation procedures


Heavy menstrual flow is a common occurrence affecting 10-35% of women, and a common reason for visits to the gynecologist.  Though the causes for heavy menstrual periods may vary, an Endometrial Ablation procedure is an excellent treatment option for many women, when child-bearing is completed.  The most popular procedures are the Novasure and the Minerva endometrial ablations.


As an Ob/Gyn physician with greater than 15 years of experience performing Endometrial Ablation procedures (and with hundreds of satisfied patients having selected the procedure), I thought it may be helpful to discuss common questions from patients  who may be considering the procedure. Here are my answers to 5 common patient questions regarding endometrial ablation procedures:


1.    How is the procedure performed?/What can I expect from my menstrual flow after the procedure…lighter periods or no period?


The procedure is considered minimally invasive, and is performed through the vaginal aspect without surgical incisions.  The ablation wand is inserted within the uterus, where a short (less than 2 minute) cauterization of the uterine lining occurs.  The procedure may be performed in an outpatient surgical setting (with anesthesia) or possibly in your doctor’s office.  You should expect to be back to normal activities within a day or so.

Several research studies on the results of the Endometrial Ablation procedures note over 90-95% patient satisfaction with the procedure.  Expected results range from notably lighter menstrual periods…to skipped/or absent menstrual flows (ranging from 40%-60% of patients.)  It’s not possible to predict for patient’s what result they will get, but when questioned overall, most patients are (very) satisfied with the results achieved.


2.    How long will the results last?

Most studies done looking a long term results of the Endometrial Ablation procedures followed patients out for a 5 year time period.  From a practical perspective, most patients have continued to have satisfactory results that last.  The return of heavy or abnormal menstrual bleeding (frequent bleeding, even if light) may require further investigation, and should be reported to your physician.


3.    Is an Endometrial Ablation procedure right for me if I’m not sure I’ve Completed Childbearing?


Since the Endometrial Ablation procedures involve a surgical destruction of the lining of the uterus, pregnancy after an Endometrial Ablation is not recommended.  Destruction of the uterine lining may result in an abnormal ‘attachment’ of a subsequent pregnancy (at implantation), increasing the risk for miscarriage, preterm birth, or placental complications.  Appropriate candidates for an Endometrial Ablation procedure should be certain that they have completed their desires for childbearing, ensuring effective contraception (most commonly by female sterilization or male partner vasectomy.)  Some candidates may opt to have a female sterilization procedure (‘tubal ligation’) done concomitantly, at the same time the Endometrial Ablation procedure is performed.  The Endometrial Ablation procedure itself does not protect against pregnancy.  Women choosing an Endometrial Ablation procedure for the treatment of heavy menstrual periods must ensure proper contraception.



4.    If I stop having periods after an Endometrial Ablation procedure, am I Menopausal?


Menopause is defined as the cessation of menstrual periods for > 1 year (typically with the onset of hot flashes), due to a ‘naturally occurring’ decline in our ovarian hormone levels, usually occurring in women in our late 40-mid 50’s.  While it is possible to ‘naturally’ become menopause at some point after having had a Endometrial Ablation procedure,  most cases of cessation of menses following tan Endometrial Ablation are likely due to the results of the procedure itself, rather than ‘menopause’.  If your monthly period stops occurring as a result of the Endometrial Ablation procedure itself, this is not considered ‘menopause’.  The lack of menstrual flow is based on the destructive process of the uterine lining, an expected result of the procedure, and not because of any decline in our hormone levels.  Endometrial Ablation procedures cauterize the uterine lining only, and do not directly affect our ovarian hormonal cycles.


5.    How long after the procedure before I can have sex again?


After most procedures/surgeries involving the cervix and uterus, physicians usually recommend a period of ‘pelvic rest’ (meaning no douching, sex or tampon use) to minimize the risk of post-procedural infection while healing.  That ‘wait’ time may vary according to different physicians, but is usually around 2-4 weeks.



Hopefully this Q/A helps you to better understand the Novasure and Minerva Endometrial Ablation procedure for your heavy menstrual periods.  Be sure to consult your own physician for specific questions/concerns regarding the procedure, and in considering Endometrial Ablation as your treatment choice.



Suzanne Hall, MD, FACOG (@drsuzyyhall)

Eastside Gynecology Obstetrics,  offices in Roseville, Grosse Pointe, Rochester, Macomb, MI

Founder of GynoGroupie.com - A modern approach to learning about your Female Health, authored by Ob/Gyn physicians

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