Experts estimate that 20 percent of women experience excessive or prolonged menstrual bleeding at some time during their lives, particularly as they approach menopause. A new, less invasive procedure called global endometrial ablation (GEA) preserves the uterus, while decreasing menstrual bleeding and shortening patients’ recovery time. In an article published in the January issue of Obstetrics and Gynecology, Mayo Clinic researchers attempt to determine the percentage of women who do not achieve permanent symptom relief from GEA and identify several factors that put women at greater risk for this outcome.
For decades, hormone pills or hysterectomy, surgical removal of the uterus, were the standard treatments for excessive or prolonged menstrual bleeding. Although numerous studies have established the safety of GEA, some women who undergo this procedure require additional treatment or hysterectomy later because significant menstrual pain or heavy bleeding symptoms resume.
During this procedure, surgeons use an energy source (heat, cold and microwave or radiofrequency energy) to destroy just the uterine lining (endometrium) and leave the uterus intact. Once the cells or the tissue that line the uterus are destroyed, scar tissue forms, and monthly menstrual flow and any accompanying pain typically decrease.
Compared to hysterectomy, the newest forms of GEA were initially thought to be equally effective, with slightly lower complication rates and costs.
“We’ve known for the past five to six years that global endometrial ablation devices are very effective,” says Mayo Clinic gynecologic surgeon Abimbola Famuyide, M.B.B.S., one of the study’s authors. “But some physicians have observed that up to 30 percent of patients may require additional treatment five years and beyond after undergoing ablation.”
According to the Mayo researchers, identifying risk factors that affect treatment outcomes following GEA is an important advance in this field. This knowledge can help surgeons determine whether GEA is appropriate for a specific patient and help them provide patients with better guidance when choosing a treatment option, say researchers.
“Optimizing preoperative patient counseling and patient selection could allow failure rates associated with GEA to decrease,” explains Dr. Famuyide.
Below is a link to an edited a youtube video with Dr. Famuyide.
13 Comments
I had an ablation to treat heavy bleeding (ongoing for a year) for heavy bleeding. At the same time removal of a chocolate ovarian cyst and removal of one overy. My bleeding is greatly reduced but it is nine weeks later and I am still bleeding. Doctor gave me antibiotics for a week. Bleeding stopped for 3 days then resumed. Now Doc. is on vacation nurse says wait a week and call back if still bleeding. Is this normal? Thanks for any input.
Depending on your definition of “heavy menstrual bleeding” I think one could say that nearly 80% of women actually suffer from this. It is all too common. Most of my friends complain at least part of the time that their periods keep them from doing things they like to do – or are we talking close-to-death type bleeding here?
Menstrual Cramp Remedies
Hello Jeanie,
I’ve passed your question on to Dr. Famuyide’s office. Thanks for your time.
Amy
I had an endometrial ablation on March 13, 2009. After a week I stopped all bleeding. All of the sudden yesterday I had light bleeding, less that 24 hours now, it is very heavy and with clots. My on call nurse for my doctor said to that it is fine as long as I don’t soak through a pad in one hour. I am very close to it. I know some people resume their periods, but this doesn’t seem like a regular period. By they way before March I had heavy bleeding every single day for 8 years non stop. No breaks not even one day. I have had 4 blood transfusions and am anemic and even have hair loss. I have PCOS also. What can I do? What is going on? Why did the bleeding start again? Is this normal?
It is good that you are in contact with your local health care provider in this situation. Thanks for your questions. I am passing them along to Dr. Famuyide’s office.
I had it done on 3-20-09 and I did fine two weeks after. Just some discharge. Then in the 3rd week I was bleeding all over the place, we had to buy pads to go under me so I would not bleed thru the sheets. I was wearing 2 overnight pads and changing them every hour an a half. My husband call the dr. because we were at the table and my back started to hurt really bad, so I got up from the table and felt some thing guss in my underwear. I went to the rest room and I had a clot come out of me that was the size of my hand, it felt like jello coming out. The nurse said that was ok, as long as I was not feeling a pad in an hour. But I was and we told her that I had to start throwing away my sweat pants becuase I was soaking thru them. The dr said that some times after the surgery becuase of the meds they use to put you to sleep that you can have a reall hard peorid and it can take up to 6 mts for your peorids to stop. I did not know that and I am just braceing my self for the next one, they are worst then before I had this done.
Ok I have written before. I had an endometrial ablation on March 20th and started bleeding heavily again. My doctor performed a second endometrial ablation on May 11th and all went well until a few days ago.My bleeding is back AGAIN!!! He told me that after 2nd ablations there would most likely be no bleeding not even periods yet here I am again. I dont know what to do. After my 2nd ablation he said if it happened again I would have to have a hysterectomy. Im 32 and don’t want to do that. Is there anything else I can do?
I had my ablation January 2009. I had no bleeding until July 11 with pain so bad I had to go to the ER. I was not given a choice of another ablation and have decided to have a hysterectomy. I am 51 and I feel I have tried everything I can to stop the heavy bleeding.
Individual results for any given procedure will vary based on the patient’s individual circumstances. If you would like to seek an appointment to be seen at Mayo Clinic to review options, you may call 507-266-8680 to request an appointment.
I had my Endometrial Ablation done in Nov. of 2007. Yesturday 1-9-10 I started feeling sick and then all period symptoms started. Then i started to spot a very brown bloody show. Today 1-10-10 my symptoms are worse cramps almost unbareable and now i have a bright red bloody show. I need to know if this is normal? I’m going to call my doctor in the morning to get an appointment to find out.
It’s good that you plan to contact your health care provider in the morning. However, if you think your situation needs urgent attention, call 911.
I had endometrial ablation done in October, 2003, for extremely heavy bleeding leading to anemia and extremely low feritin levels. After the ablation I rarely ever bled and if I did it was only a spot. It was wonderful!
In September, 2009, I experienced extreme lower abdominal pain and was taken to the ER. It was determined that there was a great deal of fluid in my uterus that wasn’t draining, and my uterus was fairly enlarged. The following day, my gyne did a D&C removing a great deal of the old material. The reason the old material didn’t drain was because scar tissue had formed in the opening between the uterus and the cervix. After all this time, it appears that my bleeding problems have returned – some times I will go through 2-3 overnight pads in 1 hour. The bleeding is unpredictable. In addition, my gyne has had to open the cervix a few more times. Taking birth control pills has helped reduce the bleeding, but they have greatly increased my migraines.
Am I a candidate for another EA? I am 51.
Thank you. We will email you with a reply.