Hysterectomy & alternatives
Endometrial ablation — pros and cons
Endometrial ablation can be a useful alternative to hysterectomy when other less invasive measures fail or, for example, if a woman does not wish to try medical (hormonal) management, and she is intent on keeping her uterus.
The word ablation means “to remove by erosion, melting, evaporation, or vaporization.” Endometrial ablation is performed with a hysteroscope, together with a device which heats up, freezes or lasers the endometrial lining. By destroying a layer of the endometrial lining, periods in the majority of cases stop altogether — at least for a while — and most women cannot get pregnant after uterine ablation therapy.
This procedure can be done by a trained GYN in the office relatively quickly and easily. It can also be useful for selectively treating areas of the endometrial lining; for example, it can be performed under anesthesia following hysteroscopically–guided D&C sampling, which may be ideal to rule out pathology rather than assuming an endometrial biopsy is adequate.
At Women to Women we do not often send women for this procedure for several reasons. For one, we always try to go for the minimally invasive procedures and medically manage when possible, and we generally get good results with medical management of our patients with heavy bleeding. In addition, long-term results for treating heavy bleeding with endometrial ablation are not always satisfactory, with a relatively high rate of reoccurrence. Our Nurse–Educators have heard back from women in the Personal Program who have had ablation that it has failed and their heavy periods returned in a year or two. There is also some element of risk that endometrial ablation could have the effect of masking endometrial cancer later in life, because it removes the opportunity for endometrial spotting to signal that something abnormal is going on.
To sum up, endometrial ablation has its limitations. With time we can look forward to medical technology bringing us more advanced treatment alternatives to hysterectomy. But in the interim, ablation techniques do offer women and their gynecologists options that can be very useful in certain circumstances.
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements, our exclusive endocrine support formula, dietary and lifestyle guidance, and optional phone consultations with our Nurse–Educators. It is a convenient, at-home version of what we recommend to all our patients at the clinic.
If you have questions, don't hesitate to call us toll-free at 1-800-798-7902. We're here to listen and help.
We’re always happy to welcome new patients to our medical clinic in Yarmouth, Maine, for those who can make the trip. Click here for information about making an appointment.
Original Publication Date: 7/20/2006
Last Modified: 01/14/2008
Principal Authors: Dixie Mills, MD
& Marcy Holmes, Certified Menopause Clinician