Our Summary

This study looked at a tool commonly used to diagnose bleeding disorders, the International Society on Thrombosis and Haemostasis bleeding assessment tool (ISTH-BAT), in women who have heavy periods and have undergone a procedure called endometrial ablation (EA). EA is a treatment that reduces or stops menstrual bleeding by removing the lining of the uterus.

The researchers tracked the health of 71 women who had undergone EA for 2 to 5 years after their procedure. They found that 77% of the women had an ISTH-BAT score of less than 6, while 23% had a score of 6 or more.

They also found that women with a score of 6 or more were more likely to continue to have periods and have painful periods after EA. In addition, these women reported more bodily pain. However, the rate of needing additional surgery after EA was similar between the two groups.

In simpler terms, the study suggests that women who have a higher score on the ISTH-BAT before undergoing EA may be more likely to continue to have periods and experience discomfort after the procedure. This could help doctors provide better advice and treatment options for women with heavy periods.

FAQs

  1. What is the International Society on Thrombosis and Haemostasis bleeding assessment tool (ISTH-BAT)?
  2. How does a higher ISTH-BAT score affect the results of endometrial ablation?
  3. Does a higher ISTH-BAT score increase the need for additional surgery after endometrial ablation?

Doctor’s Tip

One helpful tip a doctor might give a patient about endometrial ablation is to discuss any history of bleeding disorders or abnormal bleeding patterns before undergoing the procedure. This information can help determine the likelihood of success with the procedure and may guide treatment decisions post-procedure. It’s important for patients to be open and honest with their healthcare provider about any concerns or issues related to their menstrual cycle to ensure the best possible outcome.

Suitable For

Women who are typically recommended for endometrial ablation are those who have heavy menstrual bleeding (menorrhagia) that does not respond to other treatments such as medication or hormonal therapy. Endometrial ablation may also be recommended for women who have abnormal bleeding patterns, such as irregular periods or bleeding in between periods.

It is important for patients considering endometrial ablation to undergo a thorough evaluation by their healthcare provider to determine if they are suitable candidates for the procedure. Patients with certain medical conditions, such as uterine cancer or certain uterine abnormalities, may not be good candidates for endometrial ablation. Additionally, women who wish to preserve their fertility should discuss alternative treatment options with their healthcare provider, as endometrial ablation may impact future fertility.

Timeline

Before endometrial ablation:

  • Patient experiences heavy menstrual bleeding
  • Patient may undergo diagnostic tests to determine the cause of the heavy bleeding
  • Patient may try other treatments such as medication or hormonal therapy to manage the heavy bleeding
  • Patient and doctor discuss the option of endometrial ablation as a treatment for the heavy bleeding

After endometrial ablation:

  • Patient undergoes the endometrial ablation procedure
  • Patient may experience some cramping or discomfort after the procedure
  • Patient may have lighter periods or no periods at all following the procedure
  • Patient may have follow-up appointments to monitor the effectiveness of the procedure
  • In some cases, patient may continue to have periods and experience pain after the procedure, especially if they had a higher ISTH-BAT score before the procedure
  • Patient may need additional treatment or surgery if the endometrial ablation is not effective in reducing or stopping the heavy bleeding.

What to Ask Your Doctor

  1. What is the ISTH-BAT and how is it used to assess bleeding disorders in women who have undergone endometrial ablation?
  2. What is my ISTH-BAT score and what does it mean for my post-ablation symptoms and outcomes?
  3. What are the potential risks and complications associated with endometrial ablation in women with a higher ISTH-BAT score?
  4. Will having a higher ISTH-BAT score impact my likelihood of needing additional surgery or other treatments after endometrial ablation?
  5. What steps can be taken to manage any post-ablation symptoms or complications that may arise based on my ISTH-BAT score?
  6. Are there any specific lifestyle changes or medications that can help improve my symptoms and overall health after endometrial ablation?
  7. How often should I follow up with you or a specialist to monitor my symptoms and progress after endometrial ablation?

Reference

Authors: Eising HP, Punt MC, Schermer T, Leemans JC, Bongers MY. Journal: Haemophilia. 2023 Nov;29(6):1573-1579. doi: 10.1111/hae.14872. Epub 2023 Sep 27. PMID: 37758646