The other day I walked into the examining room to see a patient for an annual exam. As I greeted her, she immediately thanked me for offering her a 90 second procedure that she felt was liberating and had changed her life. One year ago, she underwent a simple office procedure called Novasure. Prior to the office procedure she described her period as a “monthly torture that interfered with her day to day activities”. Now she was free of any bleeding. This struck a note with me that such a simple and easy office procedure produced such a life altering effect. This prompted me to write a blog about the benefits of in office endometrial ablation.
Preparing for the Endometrial Ablation Procedure
At Associated OBGYN we use multiple endometrial ablation technologies. Hands down the best procedures appear to be Novasure and Thermachoice. The basic idea is to destroy the endometrial lining that women shed each month down to the base layer. This will then prevent the lining from being able to regenerate each month. Not all women are able to undergo endometrial ablation. Contraindications include women that desire to become pregnant, bleeding between cycles, enlarged uterus > 12 weeks size and large fibroid tumors of the uterus. The first step is to perform an in office ultrasound to check the endometrial cavity. After making sure the uterus is appropriate, a simple sample of the endometrial lining is taken while in the office. The endometrial biopsy is a great way to make sure the patient will be able to tolerate the in office endometrial ablation. The reason we perform the endometrial biopsy is to make sure there is no precancerous growth in the lining of the endometrium. As long as the menstrual cycles are regular the chance of precancerous cell is very rare. Most women at this point are placed on a low dose oral contraceptive pill to thin out the lining to reduce the time and pain of the procedure.
The Endometrial Ablation Procedure
On the day of the procedure women come in to the office like they would as for an office exam. One hour prior to the procedure the patient will receive medication to reduce pain and anxiety. Once the medication has taken effect, the patient is seen in the examination room where numbing medication is place within the cervix to reduce the pain. 15 minute later the doctor with gently dilate the cervix and place a small camera to evaluate the endometrium cavity. Once the cavity is found to be normal a Novasue device is placed within the cavity. A test is performed to make sure the integrate of the cavity has not been disrupted. An energy source is activated for approximately 60 seconds. Most women describe the pain similar to uterine contraction in labor. After the 60 seconds most doctors will look back inside the uterus to make sure the entire cavity has been ablated.
Recovery from the Endometrial Ablation Procedure
After a short period of time the patient is sent home with a driver to rest and take Motrin to reduce the cramping for 24 hours. Most women will experience a slight watery discharge or minimal bleeding for 4 weeks. At associated OBGYN, we’ve performed over a hundred procedures without any significant problems. Most insurance companies cover the procedure. Over 50 % of the women will not have any further periods. The remaining 50% of the patients will have mild menstrual cycles that are significantly lighter and shorter with reduced PMS symptoms.
In summary I would have to say that there is no other gynecological procedure that is so simple, yet has such a positive effect on a woman’s life. If you have any further questions about endometrial ablation, please do not hesitate to ask one of our gynecologists.
Is there an age limit for this procedure?
I had this procedure done a couple of years ago and do not recommend it. It has left me with severe cramping as a result of the ablation being done only on part of my cavity. The pain that now comes with my cycle is unbearable and I am scheduled for a hysterectomy. I would of never opted for this procedure had I known the possible effects.
Sorry for the late response. I do not recommend performing the procedure on post menopausal patients. It’s most important to make sure the patient has heavy regular periods with no bleeding between cycles. I hope this answer help.
I am 41 yrs old and had the procedure done in July of this year..I am happy to say My periods are non existent 🙂 I do have a question the after affects..
I have lost about 10 lbs and my sex drive is up..
Have their been and studies to show this is a common occurrence ? Or is it all a coinscendence?
I had the ablation done in Dec of 2013..My sexdrive skyrocket and I have lost 10 pounds also.. I Def know the ablation is what done it because before I had it done the sexdrive was as low as it could go. Much happier.. 🙂
I am with you .. Sex drive up and have lost 5 lbs and I have had no issues .. No pain after .. My Doc said I would have discharge for 2 weeks .. I only had discharge for less then a week 😉
I just wish i would have done this years ago !!! So far I love it and is very pleased
Kim,
I do not believe there is a study that has shown improvement in libido. Research has shown a reduction in PMS symptoms. With endometrial ablation you may see an increase in iron level which may lead to increased energy. Weight loss and exercise has been show to increase testosterone level which may lead to increased sex drive.
I hope this helps.
Dr Paul Corsi MD
How long after this procedure can I have intercourse?
Jennifer You should ask your doctor. The normal time is two weeks and when the bleeding stops.
My girl friend sharlee has had several issues with endometrial tissue she had went through the process of identifying the cause. After some time she had decided to go through a hysterectomy. At the beginning of the surgery her heart stopped. She was recessitated and the cause was never ide tified.. now they say the wont do the precidure without first installing a temporary pace maker.. we have spoke with a new doctor and the possability of having the ablation procedure. My question is if a we can do the ablation without the pace maker being installed and if their is any risk of her dieng again???
Dear Dr. Corsi: I am 43, very regular, but very heavy and I basically have to miss work 1 to 2 days every month because it is extremely painful. My OBG has never offered this to me. I have not cysts… nothing, normal papsmears every year… Do you have a colleague that you may reccomend her in SAn antonio, TX? Thanks!
I just had my procedure done yesterday March 26, 2013. I was also terrified reading ll of the negative posts regarding this procedure. I had mine done in the hospital and I must say I am now in day 2 and feel okay. I am resting of course but i have no leaking, or pain or any of those effects. Like my doctor told me you have to be the “Right candidate” in order for this procedure to work, and it depends on what kind of ablation you have. I had a HTA (Hydrothermal) Ablation done. When i woke up in the recovery room there was some cramping of course, and a little spotting, which came from the procedure. After that i was fine, I am going back to my normal activities tomorrow and so far I feel fine, no spotting, cramps etc…. If you are the right candidate, I would suggest HTA ablation procedure.
Is this procedure helpful at all for women who experience menstrual migraines? I’ve had a tubal ligation, but I’m on the pill (at 45) so that I can have my period every 3 months instead of every two weeks which was happening Abiut 4 years ago. But I’m worried about strome risks being on the pill at my age.
2nd question, why is it necessary to not have bleeding between periods? I’ve had two ultrasounds to verify I had no cancerous growths. Aside from being inconvenient, they are expensive. It seems this would solve the problem.
Jennifer,
Your symptoms sound very similar to my own. I am 39, have had a tubal ligation 9 years ago. I tend to have my period about three weeks out of the month. However, I have not taken any birth control or hormone treatments. I have not treated this issue because I currently do not have insurance. And when I did, my dr refused to do a hysterectomy. I am seeing it is not recommend to have the ablation procedure if your periods are irregular. I got the tubal because I do not want children and I do not want to take pills. But, without the hysterectomy or the option of the ablation- I am at a loss. It is exhausting to have my period for 20+ days out of the month. I did see a dr. about a year ago, and had an ultra sound done- and blood work- I was only told my estrogen levels were low and I have a tilted uterus. But, beyond that “everything looked normal”. I am trying to obtain health insurance, however- I really would love some suggestions in the meantime. 🙂 I recently lost 50 lbs, but that has not helped the bleeding, heavy clotting, or cramping.
I had an endometrial and cervical ablation and cerclage done 2 days ago. I was told recovery time would be about 3 days. I have pain in my lower back and contraction like pains in the lower right side of my stomach. I can only stand for a limited amount of time. Is this normal ?
At what age are you to old for this procedure? I am in my late 40’s and my doctor says I’m to old and would need a hysterectomy.
Susanne It depends on a multiple different factors. If you uterus is less then 12 weeks size and you have regular periods with normal endometrial biopsy we perform the Novasure up into the late 40’s Age should not matter as a matter of factor studies show that these women have a better chance to not have any periods at all!
Dr. Corsi,
Incidentally, I live locally to your office. I am in Royal Oak.
Hi…I had a D&C and ablation surgery in February. I am overall happy with the surgery but have experienced weight gain. I have always eaten healthy and exercised but weight gain in my stomach is a slight inconvenience. Is there anything that can be done about this?
Thank you.
Angie,
I do not believe that the ablation has anything to do with the weight gain. As women start to age (40’s) they tend to gain weight in the lower abdomen. Keep away from the processed carbs and increase your exercise. I love the amp My fitness pal and Lose it if you have a smart phone. Best of luck!
Michelle,
Bleeding for three weeks is not normal. I would recommend an endometrial biopsy to make sure no hyperplasia or cancer is present. A good option may be an Mirena iud
I am wondering why bleeding between cycles would be a contraindication? I have had a Mirena IUD for three years for the treatment of menorrhagia. My typical period used to be 9 days of heavy bleeding. Now (on the Mirena) my periods are very scant, but still last 6-14 days. I do occasionally have spotting between periods. Would this disqualify me from this procedure, and why? I would like to have fewer days of bleeding; some of my cycles are only 20 days in duration, and to be bleeding for over half of them is not fun even if it is light.
Litsah,
Irregular bleeding is a common side effect from the IUD. If your periods were 8 days pior to the iud then you would be able to have the Novasure. I would recomend the iud removal and endometial biopsy. Then go for the novasure. Good luck!
I am curious as to why my insurance company is “reviewing” my case before approving my vaginal hysterectomy. The insurance company is insisting that I must first fail at endometrial ablation before they will cover my hysterectomy. I am 36, have three children all delivered vaginally and uncomplicated. My husband had a vasectomy two years ago. I have heavy periods that last up to 14 days with as little as 7 to 14 days between my cycles. I told my GYN that I feel lucky if I get two whole weeks between my periods. I experience persistent cramping which is present almost all the time and gets a lot worse during my periods. I also have a severely retroverted uterus. This has been documented by ultrasound. It is so bad that my GYN said it goes almost directly backwards and it is difficult to reach my cervix for routine pap smears. I recently had my annual pap which came back normal and my uterine biopsy was normal as well. Since my child bearing days are behind me, and after discussing my options with my GYN and mutually deciding on a partial vaginal hysterectomy, I thought everything was ready. Now with three days to my scheduled surgery, my insurance company is the only hold up. It took a lot to mentally prepare myself for this step and now that I am ready, this snag is extremely depressing. My mother failed three ablations before her hysterectomy and suffered for over a decade. She didn’t want the same for me and neither did I. Is this a new trend, that you must first fail the ablation before a partial hysterectomy is covered?
Amy, my insurance is doing the same thing. Did you ever get yours resolved? What was the outcome?
To put it simple this is the way the insurance company is trying to save money. Sometimes they will make sure you have tried birth control pills to reduce heavy bleeding or have gone with ablation. It’s all in the documentation.
I dont have no sex drive after having this surgery done.i want one.and why would intercourse hurt evefy time.never did before until I had this done.almost six months ago.
I am 30 years old. I have two children both delivered csection. I’ve had a tubal ligation and since the age of 14 have suffered with heavy periods clotting and VERY painful cramps. 90% of my emergency room visits were due to menstrual cramps. Would I be a good candidate for this procedure? I’m hoping the answer is yes I cannot deal withthis much longer. Thank you
I am 40 years old and have been struggling with severe cramps and heavy bleeding which left extremely exhausted drained as well as not being able to function at work or out of the house during this time. Prior to losing my job thus my health insurance 2 years ago I was prescribed Seasonique which did work but it had taken three months to work consistently. It was so embarrassing when I would flood or basically wear two long Poise pads together with a tampon. So since then I have suffered however, my current work environment allows me to work from home it is still a very tumultuous pain sometime feeling as if I was in labor. Even in between menses I have pain sexual intercourse (forget about it) It is not even worth it. So now I have been given the option even though I had gone into my OBGYN’s office hell-bent on having a hysterectomy they wanted to run tests do biopsies, and when the results came back the Dr determined that I was a good candidate for Thermachoice. I sincerely want to be done with a period all together so I hope and pray that I am one of the luck few that never have a period again, not even spotting. #prayfornomorebleeding
#hopethisworks
I had the hydrothermal ablation done yesterday and it is 24 hrs later and I feel really good. I had real bad cramping and slight bleeding for the first 10 hrs but it started to go away around midnight. I had really heavy periods with large clots and severe cramps that made me unable to move or walk. I also have fibroids but they were very small less then 3cm I was told so I was a good canidate for this procedure. I will have to see how things go from here as far as my cycle goes.
I am having an ablation done for the second next week. The first time I had it done, I was put to sleep and woke and it was over. It was not successful so we are repeating it for the 2nd time, by another provider. But this Dr. does the procedure in the clinic, I am going to take 2, 10g of loritab and one xanex an hour before the procedure. I will have an IV and Demerol l if the pain gets too much. I am super super afraid of the pain. Can anyone reassure me that this will not be too much?
I have reached the end of my rope. I am 48, long since finished having children, have anemia due to heavy and very clotted periods that continue to get longer and heavier. My doctor mentioned this procedure which I originally rejected but as the symptoms continue, I have warmed to the idea. I have done some research and see there are many different ways to go about it. How do I know which is right for me? Just how serious are the risks of heat and cold damage to surrounding organs? I have also seen many not so encouraging reviews where women have experienced a lot of pain afterwards, often continuing on to be worse than what they were dealing with before the procedure. Many had no periods for awhile and then they came back full force, sometimes lasting much longer. My biggest concern is how to choose the right doctor. Is this so simple that any Doctor can do one on occasion or is it best to see someone who performs this specific procedure on a regular basis, daily or hourly even?
Lorinda I am 45 and my symptoms and situation are exactly like yours. I am anemic now and have been bleeding like you since late Oct 2014. We tried a D&C and provera prescription, neither of which worked. I had the electric thermal ablation this morning and so far am feeling fine. In the hospital it was performed under General Anesthesia and they gave me something for anxiety before I went in. I am feeling only slightly occasionally crampy but overall I feel great. For me it was the right thing to do. I hope you are feeling better soon. I know it is not fun. Take care.
Do you have to have a tubal ligation or essure before an ablation?
I had the ablation done last month and had my period the day after. Then the discharge I was warned about. Now, a month later, I have my period again. It’s as if the procedure never happened.
What are my options now?
I understand there are different types of ablation, could I try the other one? I’d like to avoid a hysterectomy.
Hey Karen, I am about to have this procedure done next Friday and I just want to make sure it goes well. I see you said your period’s came right back. How is everything going for you now.
I am 2 days post procedure. I feel OK but I am experiencing a lot of gas and burping and bloating…my face is flushed but I don’t think I have a fever…I am wondering if this is a usual side effect or am I experiencing something abnormal.
I had the ablation, D&C, hysteroscopy, & tubal 6 days ago and feel so much better! I am 36, have 2 children, and had uterine bleeding for almost a yr straight. I had 3 blood transfusions in under a year because I bled so long and heavy. I became severe anemic levels being as low as 4.9 and staying around 6-7. I was terrified of surgery and the thought of hysterectomy(hormonal reasons). I researched endlessly and finally made the decision to do the ablation. I have no pain or bleeding at this point. Mild crampiness, no biggie.I wanted to share my experience, as this has improved my life.
Hi Kim,
My symptoms were very similar to yours, I had a large fibroid (6cm) and heavy bleeding and clotting for months at a time without a break. It caused low iron and hemoglobin which was consistently at transfusion level, and my hair started falling out in droves. I had the hysteroscopy ablation done Sept 10th 2015 so I’m still bleeding very lightly but I had absolutely no pain post procedure other than the first 15 minutes which was due to pressure of seriously needing to go to the bathroom, I feel better than I did the day before I went in and the hair loss also stopped immediately. So my question is now that it’s been a few months for you how is it working for you?
I had the obliation surgery done 2 weeks ago, I am having a yellow discharge when I wipe. Went in for my post op check up 2 days ago, my dr cultured it, awaiting the results. But I feel like I am burning down there.
Hi,
I had the oblation done in May 2014 The bleeding didn’t stop until late July 2014. But now, I FEEL GREAT!!! No periods.. but, ive gotten really lazy and gained a lot of weight (Im 39) Im going to step up on my cardio. One day 🙁
I had this procedure done about a year ago. No more periods and absolutely no issues. Very happy with the results.
I had the oblation done September 2012. I have been period free untill tonight, April 11, 2015. Is this a delayed April fool’s from mother nature, a fluke, something serious,do I need to contact the Dr? Kind of a little scared here.
I had the NovaSure procedure done last week in the hospital. I had to have it at the hospital because during the initial ultrasound, my Doctor saw polyps. Well, when I went in I had been bleeding for 3 weeks. Prior to my Doctor recommending the Novasure procedure I would menestrate for 3-4weeks at a time, very heavily. I was literally have a period weeks at a time. Now, I have not had any bleeding what so ever. Just the expected discharge. I am so happy, I can do my normal activities and live my life without worrying if I am going to start my period, or if I am going to soak through my tampon and pad.
I’m going in June 1st 2015 for the nova sure. I have 3 children 3 csections and a tubal .my period would last 3 weeks to a month and it was bad bleeding ! I’m afraid of what’s going to happen I truly don’t want my period but I don’t want a hysterectomy because I’m healthy no cancer or anything I’m very lucky.
How old does one have to be for this procedure?
I’m 55 and still have monthly periods. My mom stopped at age 51…..my cycles have been the same since age 13, never an issue. All normal paps, no issues BUT going to Europe next year and DONT want to deal with a monthly cycle. My doctor told me I need a vaginal ultrasound and maybe a uterine biopsy…..after reading some of these negative things that have happened to some women, I am re-thinking of having the ablation. Shouldn’t I be finished with having monthly cycles?
I’ve had the novasure done. Its been 20 days in and I see a difference already. First week 1day of light spotting and very little discharge. Second week heavier discharge burnt smelling some watery. Third week two day of light bleeding, one blood clot. Today still watery discharge and down 10lbs. A little cramping here and there. But over all satisfied. Hoping this week is the end if the gushing light pink discharge. Excited the burnt smell is going away. Did my two week check up few days ago. Aloud to have sex now. But waiting for discharge to stop n burnt smell to go completely away. But satisfied as of today 12-18-15. Will follow up in a couple weeks.
I just had a hystercospy oblation done today 12/21/15 & I feel great!? already!! Spotting just a little! No cramping! Before I gotten this surgery. I were in pain. I had this surgery because of heavy bleeding alone with fibroids. So I recommend this surgery to anyone who are having these problems!? it works! Thanks Dr.boiler!?
I’ve been postponing having the ablation done because I am terrified of having an endometrial biopsy done. I had a sonohystogram done where fluid was inserted through my uterus to see if the small fibroid I have is pressing against the uterine lining and that was a very uncomfortable procedure. I cringe during Pap smears or any Gyn examination so I know that any doctor would have a difficult time doing a biopsy on me succesfully. The GYN who did the sonohystogram told me there were no signs of polyps or any cancerous cysts, so is it really necessary to have an endometrial biopsy done after a sonohystogram? And if so, can it be done during the ablation so I don’t feel any pain?
Hello everyone I am 37 and am having a tubular ligation and ablation tomorrow JAN 22 2015. I am nervous and praying this puts an end to my horrible cycles.
1/22/2016 surgery date sorry
I am 31 and have had my tubes tied for 5 yrs i have suffered with menstrual migraines almost all my life ive tried every birth control and every migraine pill and home remedy. Nothing seems to help my mood swings are horrible and uncontrollable i feel so run down and sick each time aunt flow comes to visit, not to mention the migraine can last for up to 2 weeks at a time. And now this past year i have started to get my period twice a month so theres no relief. I have heard that having an ablation done would help with all of these symptoms. Some feed back would be greatly appreciated.