Our Summary

This study looked at the rate at which women stop having periods (known as amenorrhea) after two types of treatments for heavy or irregular bleeding: transcervical endometrial resection (TCER), where the lining of the uterus is removed, and radiofrequency endometrial ablation, which uses heat to destroy the lining of the uterus. These treatments were sometimes combined with a hormone-releasing device placed in the uterus (LNG-IUD).

The study found that about a quarter of women who had TCER stopped having periods, but this increased to over half when the treatment was combined with the LNG-IUD. For women who had radiofrequency endometrial ablation, around 41% stopped having periods, increasing to 63% when combined with the LNG-IUD.

The results suggest that combining either type of treatment with the LNG-IUD can be more effective in stopping periods. However, the difference for the radiofrequency treatment wasn’t statistically significant, meaning it could have happened by chance. More research is needed to look at the effects of different methods on stopping periods.

FAQs

  1. What is the rate of amenorrhea in women after undergoing transcervical endometrial resection (TCER) and radiofrequency endometrial ablation treatments?
  2. Do the rates of amenorrhea increase when these treatments are combined with a hormone-releasing device placed in the uterus (LNG-IUD)?
  3. Was the difference in rates of amenorrhea statistically significant when radiofrequency treatment was combined with the LNG-IUD?

Doctor’s Tip

It is important to discuss with your doctor which treatment option is best for you based on your individual health needs and preferences. Additionally, it is important to follow up with your doctor regularly to monitor your progress and address any concerns or side effects that may arise.

Suitable For

Patients who are typically recommended for endometrial ablation are those who have heavy or irregular menstrual bleeding and have not responded well to other treatments such as medication or hormonal therapy. Endometrial ablation may be considered for women who have completed childbearing or do not wish to have children in the future. It is important for patients to discuss their medical history, symptoms, and treatment goals with their healthcare provider to determine if endometrial ablation is a suitable option for them.

Timeline

Before endometrial ablation:

  1. Patient experiences heavy or irregular menstrual bleeding.
  2. Patient consults with a healthcare provider about treatment options.
  3. Patient undergoes initial evaluation and assessment to determine if endometrial ablation is a suitable treatment option.
  4. Patient discusses potential risks, benefits, and alternatives with healthcare provider.
  5. Patient schedules endometrial ablation procedure.

After endometrial ablation:

  1. Patient undergoes endometrial ablation procedure, which can be done in an outpatient setting.
  2. Patient may experience cramping, spotting, or discharge in the days following the procedure.
  3. Patient is advised to avoid strenuous activities and sexual intercourse for a certain period of time.
  4. Patient follows up with healthcare provider for post-procedure evaluation and monitoring.
  5. Over time, patient may experience a decrease in menstrual bleeding and eventually stop having periods altogether (amenorrhea).
  6. Patient may experience improvements in quality of life and symptoms related to heavy or irregular menstrual bleeding.

What to Ask Your Doctor

  1. What are the potential risks and side effects of endometrial ablation?
  2. How long does it take to recover from the procedure?
  3. Will I still be able to have children after endometrial ablation?
  4. What is the success rate of endometrial ablation in reducing or stopping heavy menstrual bleeding?
  5. Will I need any additional treatments or follow-up appointments after the procedure?
  6. How long does the effect of endometrial ablation last?
  7. Are there any lifestyle changes I should make after the procedure?
  8. What are the chances of the heavy menstrual bleeding returning after endometrial ablation?
  9. Are there any factors that could make me a poor candidate for endometrial ablation?
  10. Are there any alternative treatments that I should consider before deciding on endometrial ablation?

Reference

Authors: Heinemeier IIK, Messerschmidt L, Kragsig Thomsen T, Bertelsen PK, Rudnicki M. Journal: Arch Gynecol Obstet. 2023 Feb;307(2):493-499. doi: 10.1007/s00404-022-06790-z. Epub 2022 Sep 21. PMID: 36129518