Endometrial Ablation vs Hysterectomy

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I am 52, have had hotflashes for 2 years. Went off the Pill a year ago and since then I have had extremely heavy bleeding. Periods last 10-16 days. Unpredicatable cycles, anywhere from 2 weeks between periods up to 3 months.

I have tried diet, I have tried various supplements. Latest try was progesterone cream which did seem to help.

Doc decided to do tests. I had all kinds of blood work done, an edo biopsy, a pelvis ultrasound. finds were that I have 2 very small fybroids and one tuiny cyst, all blood work was good. Doc wants to consider surgery and has suggested a endometrial ablation. However, I have done some research and I am not encouraged. many women who have had  endometrial ablation  have found that the poroceedure did not do as they had wished and many ended up having a hysterectomy.

My doctor today told me that many women end up having hysterectomies becasue nothign will stop their bleeding.

I am wanting some input. Have you had a endometrial ablation? What was your outcome? Hysterectomy? Was it a good choice? Was your doc hesitant? Mine says they like to keep the organs if possible. Is there any way that more blood work can be done to predict the end?

Any helpful advise would be appreciated. If you ahve found something that works please let me know.

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12 Replies

  • Posted

    Hello. I am in perimenopause for four years now and I have not had what your are going through but I was wondering if having the cyst do you have pain in your ovaries? I have this especially during sex and I am worried that I might have something like this.
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    • Posted

      No pain. Terrible cramps at times and doc said the heavy bleeding could be do to the fubroids even though they are very small. The cyst is approx 1 mm and doc says it is harmless.

      When you say you have been perimenopausal for 4 years, at what point was that determined? When you sarted having hotflashes? Or theru blood work?

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    • Posted

      As you're one of the lucky ones who actually still has a sex life(!), but you are getting pain, I, even with my aversion to all-things medical, would defo get down to my GP -pronto!!!

      I'm so glad one of us is 'getting some' - don't let something that may easily be dealt with stop you enjoying your love life........I'm just trying to remember the last time I had sex!!!

      Go do it for the rest of us!!:-) :-) :-) :-) :-)

      Sx

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  • Posted

    I have been bleeding off and on since 4/18, I will not consider surgery, there are other hormone treatments out there.  You will stop bleeding when menopause comes.  Yesterday morning it was heavy (not crazy heavy though) and then I was very irritable all day and had had a lot cramps.  I am doing 1200 mg of Advil which sometimes helps reduce bleeding today is one of those days, I also take Shepherds Purse, although not convinced it does much.  I take  multi vitamin, iron, vitamin K and a citrus bioflavanoid (just started the last 2) this is a natural process and I would like to see how it resolves.
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  • Posted

    Hiya

    Not had any surgeries myself. One of my sisters has had a hyste - long-term gynae issues.

    Another had the ablation. Said it was the best thing she ever had. Stopped her heavy bleeding forever - never bled again, took her bleed-free into full meno aged 54 (she's now 62, been taking HRT for 8yrs. Tells me to try it. Not just yet for me, but won't rule it out).

    I also told a colleague to mention the Ablation to her aunt who was due to have a hyste that week. She had this op instead and hers too was a major success!

    Suppose it all depends on the individual and their particular symptoms.

    I'd have tried either. I've no 'attachment' to my womb (bloody nuisance most of the time). Think its a case of you having to decide which procedure may be best for you in the long run.

    Good luck, whatever you decide :-)

    Six

    PS - forgot to mention. I'm 54, still having regular P's. Had REALLY heavy bleeding in my late 40s. Was one of the few times I went to my GP. No mention of these ops for me. Was prescribed Tranexamic Acid - totally sorted me out.

    Took for a year or so then decided to see how things were/how

    I'd cope without it = fine. Think maybe aside from anything else I was 'changing' anyway as my bleed was and had been much lighter thereafter.

    I still have a bit of heavy now, but I'm under no illusions its anything near as bad as it had been. Just can't wait until they become irregular and finally stop!!

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  • Posted

    hi - i had an ablation due to severe cramping and heavy bleeding.  i had to have iv infusion one time i was bleeding so much.  the ablation did not work as well as promised...only i found out afterwards that since i have fibroids, c-section scar, tubuligation it was probably not going to work for me anyway.  now my doctors refuse to give me pain pills other than NSAIDS (which we recently found out caused an ulcer, so NO NSAIDS) and they would rather cut something (uterus) out of me and be in more pain and recovery time, than give me 3 pills per month for pain until i get through this stage where i am bleeding irregularly and close to getting through to post menopause.    always happy to cut us open though.  i'm going next month to talk to the surgeon.

    if you've had a c-section and tubal ligation, with fibroids they say it may not work.  look up post ablation syndrome.  that's what happened to me.  good luck.   

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    • Posted

      BEFORE the ablation i bled "normally",  meaning 5-7 days,  very heavy and clotty.  it weakened me, nauseated me; it felt like labor cramps.  AFTER the ablation, my periods were less clotty, but still heavy.  still normal amount of days, 5-7, and regular.  over 2 years later my periods are not as severe amount of blood, no clots but STILL have the severe cramping.  2 months ago they started to become erratic.  my last period lasted 8 days, not heavy.  the one before that (with only 14 days in between) lasted about 9 days too.  i've spotted since the last one... i have no idea when i'll start next, or how the pain or flow will be.  something new to be anxious about... booooo.
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    • Posted

      p.s.  my gf and i both had painful periods (her weren't as bad as mine) and we both tried the mirena.  hers has been in just over 4 years and she is so happy with it.  she also has small fibroids.  i left mine in place for about 9 months and it didn't change anything.  that's when i tried the ablation.  if you haven't had a c-section, or tubes tied, you should be a good candidate for the ablation; even with the fibroids.  i have those too, but it's the scarring from the c-section and tubal that has invaded my uterus and causing the severe cramps.  hope this is helpful.  smile
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  • Posted

    Ok., this is an old post, but hopefully I can give some information. I work volunarily in a hospital, & there are a lot of women who go through the surgical dept. scheduled for Novasure Ablation or hysterectomy.

    Novasure takes about 5 min. There is a small tool that is inserted into the womb, then radiofrequency pulses are sent into the womb. This ablates the lining of the uterus to a certain extent. Some lining may be left behind. Women still may have periods, & of course the womb is still intact,necessitating returning to the GYN's office yearly for paps, etc. After speaking with several woman, I'm told they would much prefer to opt for hysterectomy.That way, the uterus is gone, as are the very heavy periods & cramps. Don't permit any surgeon to leave the cervix intact. That is a common site for cancer! Leaving the cervix intact serves no purpose.

    There is no guarantee that the ablation will get rid of your problem. It can come back, & yes there's a chance you could still become pregnant, although the GYN may deny this...likely because he wants to do the ablation. I"ve seen the scheduling as well...ablation after ablation after ablation. The procedure takes just 5 min, so it's like an assembly line for the GYN. One woman was suffering heavy bleeding with cramps, etc.etc. She & her husband had completed their family. The husband had vasectomy a few years back. She herself had a tubal ligation. She told me also that she fought with her GYN because she wanted hysterectomy, & he was arguing with her that ablation should be done. Finally she told him that if he wouldn't do the hysterectomy, she'd find a doctor who would! Good for her! The Dr. finally agreed, which is why she was having hysterectomy that morning. 

    Yes, hysterectomy is major surgery, however there are a few methods of how this surgery can be performed...abdominally, vaginally, laparoscopy assisted, etc. 

    Again, if you are scheduled for or are planning your hysterectomy with the Dr., TELL him the cervix is to be removed.Don't take no for an answer. 

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  • Posted

    Hi There AVR1962. I know you posted this 3 years ago so maybe the discussion is no longer relevant. However, in 2011 after decades of very heavy bleeding during menstration i finally  I had endometrial ablation. It worked very well and I regained a significant level of health begining after this procedure. I had regular very minor bleeding each month which let me know my menstral cycle was still regular. About 2 years ago my period  started to become less regular but with no problems. I am now 52 and thought I'd been experiencing a normal mild menopause until now. For 10 months last year i had no bleeding, then late last year I had 2 normal periods. Now I've had 3 weeks of bleeding getting heavier. So I'm to the doctor today to check it out and as part of that i did a little reading and have seen that actually the lining of the uterus can grow back and with it the experience of heavy bleeding. Given that i had such a great response from the first ablation i will not let a long time pass before doing something about it again. Not sure what yet. I hope you no longer have troubles and had a successful endometrial ablation. 

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    • Posted

      Hi melissa27356...Well, it seems you've been through the gammit with this ablation topic. When this procedure started becoming better known, it was said that in ablation, the lining of the uterus was destroyed, therefore no more menstrual cycles, no more periods, however a woman still needed to have pap tests every year or two because the cervix & uterus was still intact. Now it seems this is not the case, so I ask...what's the point in ablation? While it may reduce the incidence of periods & bleeding, a woman still bleeds? Nonsense! I fail to understand 'why' the medical profession would put a woman through such a thing when hysterectomy would resolve her problems forever! These days, the procedure is called "Novasure Ablation", & takes just 5 min. to do it. It's radiofrequency that destroys or ablates the uterine lining. I know of a woman who is 36 yrs of age, her husband had vasectomy a few years ago because they were finished having any more children & she was experiencing terrible periods. Her Gynecologist was pushing for ablation, but she wanted hysterectomy. The reason the Dr. was giving her a hard time about it was because hysterectomy is a major operation. We all know that, & she argued that point, & stressed that in ablation she'd still have to attend for pap tests, etc.etc. & down the road the bleeding just may start. Their discussion became a little heated, & she said to him..."I WANT the hysterectomy, & if you don't do it, I'll find a doctor who will". The doctor then said.."well, ok..I'll do it". Yes, it's general anesthetic, yes it's major surgery, & she will be sore afterwards, but those are short term things. At least she won't have periods anymore, nor will she be required to have pap tests. 

      It's fine for Drs to tell women that Novasure Ablation is the best route to go, or to dictate this will be done, but it's the woman who must go through it. Also, the doctors are not the ones suffering with horrible periods with heavy bleeding, terrible pain, & never knowing when the period is going to start or stop. Rather than the Dr. saying "this is what's going to be done"...they should be discussing the options, & let the patient decide what's best for her.

      I for one will never encourage a woman to have Novasure Ablation when hysterectomy will forever get rid of her problems. There are a lot of women out there who seem to be wearing rosey coloured glasses when faced with the decision. They seem to be led to believe that the ablation is the golden answer to their problems. The Dr. lines up the patients...one after the other...because it's only a 5min procedure!! How do I know this???....because I do volunteer work at the local hospital & see the surgery schedule!!!!!!  Believe me, I know of what I speak..Also...the Dr. sees the patient year after year for pap tests..(making money).

      While I'm glad the ablation seems to have worked for you...you did say that the bleeding is returning & getting heavier. 

      Another thing...some drs will suggest to a patient that the problems may resolve themselves once menopause has taken place. If a woman is a few years from menopause, this means she will suffer for a few more years????? HOWEVER, the key wording here is MAY. The problems may NOT resolve themselves. I say...git 'er done!!!

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