New therapy gives women quick, effective relief

March 19, 2007
For many women with heavy menstrual bleeding, or menorrhagia, life can be a year-round battle against physical discomfort and lifestyle disruptions, not to mention awkward moments. Often relief comes only through hormone replacement therapy, dilatation and curettage, or hysterectomy, all of which can carry considerable short and long-term risks. But thanks to a new procedure at New Hanover Regional Medical Center called endometrial ablation, many women are finding permanent relief from heavy menstrual bleeding in as little as 90 seconds. “In women who cannot take hormone replacement therapy to control heavy menstrual bleeding, endometrial ablation becomes another alternative to hysterectomy,” said Daniel Robison, MD, a Wilmington gynecologist. Developed in the early 1980s, endometrial ablation destroys a thin layer of the lining of the uterus, or endometrium, stopping all menstrual flow. There are two primary ablation techniques. “One procedure uses a thermal balloon that conforms to the uterus and circulates hot water to burn and destroy the uterus lining,” Dr. Robison said. “The other procedure uses a triangular mesh device deployed into the uterus that delivers a safe electrical charge to destroy endometrial tissue.” In both cases, all devices are removed from the uterus after the procedure. With thermal balloon ablation, treatment takes about 10 minutes. With the mesh device, the uterus is treated for about 90 seconds, making it by far the fastest and most effective of all endometrial ablation methods, including laser ablation. “The mesh procedure is particularly fast and effective,” Dr. Robison said. “Studies reveal that 60 percent of patients treated with mesh ablation experience no menstrual bleeding at all after the procedure. And 95 percent report they experience only light bleeding.” There are many reasons for heavy menstrual flow, including genetics, hormonal imbalance, uterine fibroids and polyps, and peri-menopause. Approximately one in five women experiences excessive menstrual bleeding, or bleeding lasting more than seven days per cycle requiring hourly change of protection. “Some women just live with this condition, but now with endometrial ablation there’s a fast, effective way to treat it beyond just traditional methods,” said Natalie Priest, RN, NHRMC’s gynecologic surgery coordinator. Priest said between 15 and 30 procedures a month are performed at the hospital. Dr. Robison said the ages of patients undergoing endometrial ablation varies widely. “I see women in their thirties and forties who are good candidates for this treatment, as well as middle-aged women,” he said. “But only women who have completed childbearing should consider it.” Another advantage to endometrial ablation over more traditional treatments for heavy menstrual bleeding is that it can be performed on an outpatient basis, making for a quicker recovery. “They’re both minimally invasive, outpatient procedures that can be done under light or heavy anesthesia,” he said. “Most women return to work the next day, whereas with a major surgery like hysterectomy, women can usually expect a longer recovery.”For more information about endometrial ablation, please consult your gynecologic physician.