Harvard Women's Health Watch

In the journals: Endometrial ablation is shown to be safe and effective

In the journals

Endometrial ablation is shown to be safe and effective

Menorrhagia (abnormally heavy menstrual bleeding) isn't just uncomfortable or inconvenient — it can also lead to fatigue and anemia. When it's a symptom of a condition such as fibroids or endometrial cancer, it can be relieved by treating the underlying problem. When heavy periods have no known cause, women have other options, including hormonal drugs, which preserve the ability to have children, and hysterectomy, which removes the uterus. For women who are no longer interested in childbearing, another option has emerged since the late 1980s: endometrial ablation — the elimination of the endometrium, or uterine lining. This procedure is less invasive than hysterectomy and can be performed on an outpatient basis.

Until recently, there's been little evidence on the long-term results of endometrial ablation. A study in the May 2009 British Journal of Obstetrics and Gynecology helps fill the gap. Researchers reported on a 10-year follow-up of women who underwent either of two common ablation methods — transcervical resection of the endometrium (TCRE) or microwave endometrial ablation (MEA). Whichever procedure they underwent, most of the women were happy with the results. They reported less menstrual bleeding and pain and overall improved quality of life.

In the study, which began in 1996 at Aberdeen Royal Infirmary in Scotland, 263 women with menorrhagia, average age 41, who had completed childbearing were randomly assigned in roughly equal numbers to undergo either TCRE or MAE. Both procedures were performed under general anesthesia. In TCRE, electric cauterization instruments are used to remove the endometrium and seal off blood vessels. In MEA, a microwave wand is used to heat the uterus until the endometrium is destroyed.

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