Endometrial Ablation: 90 Seconds Can Be Liberating
The other day I walked into the examining room to see a patient for an annual exam. As I greeted her, she immediately thanked me for offering her a 90 second procedure that she felt was liberating and had changed her life. One year ago, she underwent a simple office procedure called Novasure. Prior to the office procedure she described her period as a “monthly torture that interfered with her day to day activities”. Now she was free of any bleeding. This struck a note with me that such a simple and easy office procedure produced such a life altering effect. This prompted me to write a blog about the benefits of in office endometrial ablation.
Preparing for the Endometrial Ablation Procedure
At Associated OBGYN we use multiple endometrial ablation technologies. Hands down the best procedures appear to be Novasure and Thermachoice. The basic idea is to destroy the endometrial lining that women shed each month down to the base layer. This will then prevent the lining from being able to regenerate each month. Not all women are able to undergo endometrial ablation. Contraindications include women that desire to become pregnant, bleeding between cycles, enlarged uterus > 12 weeks size and large fibroid tumors of the uterus. The first step is to perform an in office ultrasound to check the endometrial cavity. After making sure the uterus is appropriate, a simple sample of the endometrial lining is taken while in the office. The endometrial biopsy is a great way to make sure the patient will be able to tolerate the in office endometrial ablation. The reason we perform the endometrial biopsy is to make sure there is no precancerous growth in the lining of the endometrium. As long as the menstrual cycles are regular the chance of precancerous cell is very rare. Most women at this point are placed on a low dose oral contraceptive pill to thin out the lining to reduce the time and pain of the procedure.
The Endometrial Ablation Procedure
On the day of the procedure women come in to the office like they would as for an office exam. One hour prior to the procedure the patient will receive medication to reduce pain and anxiety. Once the medication has taken effect, the patient is seen in the examination room where numbing medication is place within the cervix to reduce the pain. 15 minute later the doctor with gently dilate the cervix and place a small camera to evaluate the endometrium cavity. Once the cavity is found to be normal a Novasue device is placed within the cavity. A test is performed to make sure the integrate of the cavity has not been disrupted. An energy source is activated for approximately 60 seconds. Most women describe the pain similar to uterine contraction in labor. After the 60 seconds most doctors will look back inside the uterus to make sure the entire cavity has been ablated.
Recovery from the Endometrial Ablation Procedure
After a short period of time the patient is sent home with a driver to rest and take Motrin to reduce the cramping for 24 hours. Most women will experience a slight watery discharge or minimal bleeding for 4 weeks. At associated OBGYN, we’ve performed over a hundred procedures without any significant problems. Most insurance companies cover the procedure. Over 50 % of the women will not have any further periods. The remaining 50% of the patients will have mild menstrual cycles that are significantly lighter and shorter with reduced PMS symptoms.
In summary I would have to say that there is no other gynecological procedure that is so simple, yet has such a positive effect on a woman’s life. If you have any further questions about endometrial ablation, please do not hesitate to ask one of our gynecologists.