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Sanford Obstetrics & Gynecology
A look at issues involving uterine bleeding
Is endometrial ablation always preferable to a hysterectomy?Thatís a decision that your gynecologist can help you make based on your symptoms and history. There are also pharmaceutical-based therapies that may be recommended to control prolonged vaginal bleeding before any surgical procedure is considered. If you experience heavy, prolonged bleeding, make an appointment with your gynecologist.
How does endometrial ablation work?Endometrial ablation destroys, or ablates, the uterine lining, also known as the endometrium. The uterine lining then heals by scarring. Most women will have reduced menstrual flow and up to one-half will stop having periods. The procedure is more successful in older women than younger women. Younger women may continue to have periods and may need to have the procedure repeated or have a hysterectomy performed. If you are a young woman, your gynecologist may suggest treatment prior to the ablation using a hormone medication to decrease estrogen production and thin the uterine lining to improve the effectiveness of the ablation.
What are the side effects or risks?Outpatient procedures like endometrial ablation have reduced risks compared to major surgeries such as a hysterectomy. Following an endometrial ablation, possible side effects include cramping, nausea, and vaginal discharge that may be watery and mixed with blood. This discharge will become clear after a couple of days and can last for one to two weeks. You will go home the same day but you should expect to take anywhere from a few days to two weeks to fully recover.
At what point should I see a gynecologist for uterine bleeding?Outside of the regular monthly menstrual cycle, uterine bleeding is generally not normal. It can be symptomatic of a wide range of possible health concerns, including serious ones such as cervical, ovarian and endometrial cancers. Vaginal bleeding should be investigated immediately in young girls who havenít begun their cycle. Women who begin bleeding while pregnant should call their obstetrician/gynecologist (OB/GYN) immediately. Uterine bleeding after menopause must also be evaluated. In any case where bleeding is prolonged, itís important to get the cause diagnosed and begin treatment. If you have experienced heavy uterine bleeding for one to two months or have associated symptoms such as fatigue or weakness, make an appointment with an OB/GYN.