Endometrial Ablations (EA) with Brad Adkins MD

In general, what is an endometrial ablation?
An endometrial ablation is an office based procedure or outpatient surgery that can be used to treat women that are having heavy menstrual flow, also known as menorrhagia.

What are the different types of endometrial ablations?
There are a number of endometrial ablations but the goal is pretty much the same with any of them: it’s to destroy the inner lining of the uterus so that women’s periods are much lighter or disappear all together. Some common ones are cryoablation, which is freezing of the inner lining of the uterus. There is also radio frequency, called NovaSure. There are a couple others called thermal balloon ablation and hydro, which uses water to destroy the inner lining.

What does an endometrial ablation treat?
Primarily, it treats menorrhagia, or women that are having heavy menstrual flow.

Which women should undergo an endometrial ablation?
Candidates for the endometrial ablation procedure are women that are having excessive menses and are through having children. Women that still desire having children should not have the endometrial ablation performed.

What are some complications and risks for women who have undergone an EA?
There are a couple of risk factors or complications associated with the ablation. Primarily, there is a small risk of perforation, basically sticking a hole through the uterus. That probably sounds worse than it is, but the problem is that the procedure can not be completed and may have to be postponed. Additional risks include infections that can develop and bleeding that requires extra surgery to control. One of the other risks is the fact that the endometrial ablation may not work. In most women, it is highly successful; for a small percentage, they still have persistent bleeding, which would require additional treatment and/or surgery

How successful are endometrial ablation procedures?
Roughly 85% of women will respond to the endometrial ablation, and response or efficacy can mean periods much lighter or no periods at all. Roughly half or 40% of women will have no periods at all after completing an endometrial ablation procedure.

In conclusion, why do you think women eligible for an endometrial ablation should choose to have an endometrial ablation procedure done over other treatment options?
The endometrial ablation procedure is a great choice for women that are having the heavy flow. At the Woman’s Clinic, we try to tailor the treatment for each individual patient. Sometimes, medical management is still the best form of treatment. For other women, an ablation may be the better alternative. We used to do hysterectomies all the time for women with similar problems of heavy flow, but the ablation is a better procedure from the standpoint that it’s less invasive, therefore less risk factors come into play, and their recovery is much faster with the ablation.