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Putting an end to heavy bleeding: Is endometrial ablation right for you?

At some point in her life, almost every woman experiences heavy or prolonged menstrual bleeding. But if you experience it every cycle, you know a heavy period can be more than a nuisance. Severe blood loss can lead to anemia, and excessive pain and fatigue may cause you to miss work or other activities. A minimally invasive surgical procedure, endometrial ablation, can be an effective treatment.

Is this an option for me?

Endometrial ablation uses either heat, cold or electrical energy to destroy the uterus lining, or endometrium. A surgeon delivers the energy through the vagina and cervix with a laser, electrocautery tool, thermal balloon or fluid. The procedure minimizes or ends menstruation, but it also effectively ends fertility.

Ablation works well for many women with heavy or prolonged bleeding who have tried other treatments but is not for everyone. While ablation can treat excessive bleeding caused by uterine fibroids, it won’t shrink or remove the fibroids, so patients may still suffer pain and pelvic pressure. Your doctor will need to determine why you’re having abnormal bleeding and whether ablation is right for you.

Why might you want it?

It’s less drastic than hysterectomy and usually done as outpatient surgery. Most women can return to normal activities several days later. Endometrial ablation leaves your uterus, ovaries and cervix in place. Your menstrual bleeding will be minimized or eliminated. And, unlike a hysterectomy, you won’t experience premature menopause.

Why might you pass on it?

If you think you may want to become pregnant, ablation is not for you. Also, as with any procedure, risks include complications from pain medication, blood loss and infection. In rare cases, the surgical device may pass through the uterine wall or bowel or the fluid used to expand the uterus may pass into the bloodstream. In addition, if menstruation stops, it’s possible that light periods may resume within 10 years.

In considering endometrial ablation, you and your doctor should evaluate your age and overall health, the condition’s impact on your lifestyle and whether you want children.