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My Disrespectful Uterus...and Heavy Periods

Heavy periods can control your life! You must wear a certain type of clothing or ugly underwear and a certain color, usually black. You must drive to work while sitting on a towel just in case you have an accident. You must walk a certain way because you are afraid to shift that SUPER pad in a different position that causes leakage. You cancel a date night because your period started, and you are afraid that you’ll have an accident while in public.

These are all true stories I’ve heard from various women, and this is no way to live. Many thought that this was normal and was just dealing with it. Others were afraid to mention it because she thought her only option to solve this problem is a hysterectomy. There are options other than a hysterectomy that are available to make periods more tolerable. These options include hormonal contraception like birth control pills or Nuvaring and the Mirena IUD is FDA approved to treat heavy periods.

There are some women who do not want to go back on birth control or start birth control to lighten their periods. Some women are not candidates for hormonal birth control that contains estrogen-smoker, history of migraines with an aura, history of a blood clotting disorder, history of having a blood clot in a lower leg vein called a deep vein thrombus or DVT or a blood clot in their lung called a pulmonary embolus or PE.

Endometrial or Uterine Ablation is an option to consider!

It is a minimally invasive outpatient procedure that uses different energy sources to obliterate the uterine lining (endometrium) to make it very thin with the goal of reducing the menstrual flow or eliminating it all together!

There are 5 types of ablation:


-Cryoablation (Her Option)

-Hydrothermal (Hydro ThermAblator or HTA)

-Heated balloon (ThermaChoice)


-Radiofrequency (Novasure)

The types that are used are based on physician preference, availability, and the size of the uterine cavity. Some physicians may choose one type of ablation over another if

a woman has a larger uterine cavity. I prefer the Novasure ablation.

The American College of Obstetrics & Gynecologists (ACOG) states there is an 85-95% satisfaction rate among women who undergo an ablation. Satisfaction was quantified by a reduction in menstrual flow. Periods can be much more tolerable after having this type of procedure.

Now before you can undergo this procedure, you must decide on your plans for future fertility because pregnancy is not recommended after this type of procedure. Also, you must undergo an evaluation to ensure you are a good candidate for this procedure. This evaluation includes a pelvic exam, an endometrial biopsy, and a pelvic sonogram. You may be wondering if the endometrial biopsy hurts? My answer is, “yes but it’s quick and nothing that Ibuprofen can’t manage!”

The ablation procedure is performed in the operating room under light anesthesia. Although, there are some gynecologists who have the resources to do it in their office. The actual ablation only takes 1 to 8 minutes depending which type of ablation you get. Of course, like any procedure, there are risks such as pain, bleeding, infection, or damage to the uterus or surrounding structures but the chances of them happening is low. You go home afterwards and take it easy for 1-2 days then wait for your next period and hopefully be pleased to see hardly anything on that pad or tampon. There is a small percentage of women who do not see much change in their menstrual flow and will have to discuss next steps that may include a hysterectomy.

Back in the day, a hysterectomy was the common solution for heavy periods. These days, many women can avoid a hysterectomy by undergoing an ablation. Hysterectomy is MAJOR surgery so it would be nice if you could avoid it. Obviously, there are circumstances when a hysterectomy is necessary-an abnormal result from endometrial biopsy, uterus too large due to fibroids, not a candidate for hormonal treatment or an ablation, or failed other treatment options.

So, if you have heavy periods, talk to your Gynecologist to discuss your options for managing them to see which is the best fit for you.

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