Endometrial Ablation: 90 Seconds Can Be Liberating

Posted by Dr. Paul Corsi MD - January 23, 2012 - Gynecology - 26 Comments

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.

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Dr. Paul Corsi MD

Dr. Corsi is a board certified obstetrician and gynecologist with hospital affiliations at St. Joseph Mercy Oakland and Henry Ford Surgical Center. He is the Chair of Minimal invasive Surgical Program St Joseph Mercy Oakland. He sees patients at Associated Obstetrics & Gynecology's Clarkston and Bloomfield Hills, Michigan offices.

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26 comments

  • avatar Rebecca says:

    Is there an age limit for this procedure?

  • avatar Paul Corsi MD says:

    Sorry for the late response. I do not recommend performing the procedure on post menopausal patients. It’s most important to make sure the patient has heavy regular periods with no bleeding between cycles. I hope this answer help.

  • avatar Kim M says:

    I am 41 yrs old and had the procedure done in July of this year..I am happy to say My periods are non existent :) I do have a question the after affects..
    I have lost about 10 lbs and my sex drive is up..
    Have their been and studies to show this is a common occurrence ? Or is it all a coinscendence?

    • avatar Weaze says:

      I had the ablation done in Dec of 2013..My sexdrive skyrocket and I have lost 10 pounds also.. I Def know the ablation is what done it because before I had it done the sexdrive was as low as it could go. Much happier.. :)

  • Kim,
    I do not believe there is a study that has shown improvement in libido. Research has shown a reduction in PMS symptoms. With endometrial ablation you may see an increase in iron level which may lead to increased energy. Weight loss and exercise has been show to increase testosterone level which may lead to increased sex drive.

    I hope this helps.
    Dr Paul Corsi MD

  • How long after this procedure can I have intercourse?

  • avatar Dr Corsi says:

    Jennifer You should ask your doctor. The normal time is two weeks and when the bleeding stops.

    • avatar Sharlee says:

      My girl friend sharlee has had several issues with endometrial tissue she had went through the process of identifying the cause. After some time she had decided to go through a hysterectomy. At the beginning of the surgery her heart stopped. She was recessitated and the cause was never ide tified.. now they say the wont do the precidure without first installing a temporary pace maker.. we have spoke with a new doctor and the possability of having the ablation procedure. My question is if a we can do the ablation without the pace maker being installed and if their is any risk of her dieng again???

    • avatar Elizabeth says:

      Dear Dr. Corsi: I am 43, very regular, but very heavy and I basically have to miss work 1 to 2 days every month because it is extremely painful. My OBG has never offered this to me. I have not cysts… nothing, normal papsmears every year… Do you have a colleague that you may reccomend her in SAn antonio, TX? Thanks!

  • avatar Kareen says:

    I just had my procedure done yesterday March 26, 2013. I was also terrified reading ll of the negative posts regarding this procedure. I had mine done in the hospital and I must say I am now in day 2 and feel okay. I am resting of course but i have no leaking, or pain or any of those effects. Like my doctor told me you have to be the “Right candidate” in order for this procedure to work, and it depends on what kind of ablation you have. I had a HTA (Hydrothermal) Ablation done. When i woke up in the recovery room there was some cramping of course, and a little spotting, which came from the procedure. After that i was fine, I am going back to my normal activities tomorrow and so far I feel fine, no spotting, cramps etc…. If you are the right candidate, I would suggest HTA ablation procedure.

  • avatar Jennifer Newsom says:

    Is this procedure helpful at all for women who experience menstrual migraines? I’ve had a tubal ligation, but I’m on the pill (at 45) so that I can have my period every 3 months instead of every two weeks which was happening Abiut 4 years ago. But I’m worried about strome risks being on the pill at my age.

    2nd question, why is it necessary to not have bleeding between periods? I’ve had two ultrasounds to verify I had no cancerous growths. Aside from being inconvenient, they are expensive. It seems this would solve the problem.

    • avatar Michelle Boldt says:

      Jennifer,
      Your symptoms sound very similar to my own. I am 39, have had a tubal ligation 9 years ago. I tend to have my period about three weeks out of the month. However, I have not taken any birth control or hormone treatments. I have not treated this issue because I currently do not have insurance. And when I did, my dr refused to do a hysterectomy. I am seeing it is not recommend to have the ablation procedure if your periods are irregular. I got the tubal because I do not want children and I do not want to take pills. But, without the hysterectomy or the option of the ablation- I am at a loss. It is exhausting to have my period for 20+ days out of the month. I did see a dr. about a year ago, and had an ultra sound done- and blood work- I was only told my estrogen levels were low and I have a tilted uterus. But, beyond that “everything looked normal”. I am trying to obtain health insurance, however- I really would love some suggestions in the meantime. :) I recently lost 50 lbs, but that has not helped the bleeding, heavy clotting, or cramping.

  • avatar alyssa says:

    I had an endometrial and cervical ablation and cerclage done 2 days ago. I was told recovery time would be about 3 days. I have pain in my lower back and contraction like pains in the lower right side of my stomach. I can only stand for a limited amount of time. Is this normal ?

  • avatar Susanne says:

    At what age are you to old for this procedure? I am in my late 40′s and my doctor says I’m to old and would need a hysterectomy.

  • Susanne It depends on a multiple different factors. If you uterus is less then 12 weeks size and you have regular periods with normal endometrial biopsy we perform the Novasure up into the late 40′s Age should not matter as a matter of factor studies show that these women have a better chance to not have any periods at all!

  • avatar Michelle Boldt says:

    Dr. Corsi,
    Incidentally, I live locally to your office. I am in Royal Oak.

  • avatar Angie says:

    Hi…I had a D&C and ablation surgery in February. I am overall happy with the surgery but have experienced weight gain. I have always eaten healthy and exercised but weight gain in my stomach is a slight inconvenience. Is there anything that can be done about this?
    Thank you.

    • Angie,
      I do not believe that the ablation has anything to do with the weight gain. As women start to age (40′s) they tend to gain weight in the lower abdomen. Keep away from the processed carbs and increase your exercise. I love the amp My fitness pal and Lose it if you have a smart phone. Best of luck!

  • Michelle,
    Bleeding for three weeks is not normal. I would recommend an endometrial biopsy to make sure no hyperplasia or cancer is present. A good option may be an Mirena iud

  • avatar Litsah says:

    I am wondering why bleeding between cycles would be a contraindication? I have had a Mirena IUD for three years for the treatment of menorrhagia. My typical period used to be 9 days of heavy bleeding. Now (on the Mirena) my periods are very scant, but still last 6-14 days. I do occasionally have spotting between periods. Would this disqualify me from this procedure, and why? I would like to have fewer days of bleeding; some of my cycles are only 20 days in duration, and to be bleeding for over half of them is not fun even if it is light.

    • Litsah,
      Irregular bleeding is a common side effect from the IUD. If your periods were 8 days pior to the iud then you would be able to have the Novasure. I would recomend the iud removal and endometial biopsy. Then go for the novasure. Good luck!

  • avatar Amy says:

    I am curious as to why my insurance company is “reviewing” my case before approving my vaginal hysterectomy. The insurance company is insisting that I must first fail at endometrial ablation before they will cover my hysterectomy. I am 36, have three children all delivered vaginally and uncomplicated. My husband had a vasectomy two years ago. I have heavy periods that last up to 14 days with as little as 7 to 14 days between my cycles. I told my GYN that I feel lucky if I get two whole weeks between my periods. I experience persistent cramping which is present almost all the time and gets a lot worse during my periods. I also have a severely retroverted uterus. This has been documented by ultrasound. It is so bad that my GYN said it goes almost directly backwards and it is difficult to reach my cervix for routine pap smears. I recently had my annual pap which came back normal and my uterine biopsy was normal as well. Since my child bearing days are behind me, and after discussing my options with my GYN and mutually deciding on a partial vaginal hysterectomy, I thought everything was ready. Now with three days to my scheduled surgery, my insurance company is the only hold up. It took a lot to mentally prepare myself for this step and now that I am ready, this snag is extremely depressing. My mother failed three ablations before her hysterectomy and suffered for over a decade. She didn’t want the same for me and neither did I. Is this a new trend, that you must first fail the ablation before a partial hysterectomy is covered?

  • To put it simple this is the way the insurance company is trying to save money. Sometimes they will make sure you have tried birth control pills to reduce heavy bleeding or have gone with ablation. It’s all in the documentation.

  • avatar Ashley r says:

    I dont have no sex drive after having this surgery done.i want one.and why would intercourse hurt evefy time.never did before until I had this done.almost six months ago.

  • avatar Candice Pallone says:

    I am 30 years old. I have two children both delivered csection. I’ve had a tubal ligation and since the age of 14 have suffered with heavy periods clotting and VERY painful cramps. 90% of my emergency room visits were due to menstrual cramps. Would I be a good candidate for this procedure? I’m hoping the answer is yes I cannot deal withthis much longer. Thank you

  • avatar Monica says:

    I am 40 years old and have been struggling with severe cramps and heavy bleeding which left extremely exhausted drained as well as not being able to function at work or out of the house during this time. Prior to losing my job thus my health insurance 2 years ago I was prescribed Seasonique which did work but it had taken three months to work consistently. It was so embarrassing when I would flood or basically wear two long Poise pads together with a tampon. So since then I have suffered however, my current work environment allows me to work from home it is still a very tumultuous pain sometime feeling as if I was in labor. Even in between menses I have pain sexual intercourse (forget about it) It is not even worth it. So now I have been given the option even though I had gone into my OBGYN’s office hell-bent on having a hysterectomy they wanted to run tests do biopsies, and when the results came back the Dr determined that I was a good candidate for Thermachoice. I sincerely want to be done with a period all together so I hope and pray that I am one of the luck few that never have a period again, not even spotting. #prayfornomorebleeding
    #hopethisworks

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