Thermachoice Endometrial Ablation

The Menstrual Cycle

Menstruation is a woman's monthly bleeding, also called a period.   When you menstruate, your body is shedding the lining of your uterus.  Menstrual blood flows from the uterus through the small opening in the cervix, and passes out of the body through the vagina.   Most menstrual periods last from three to seven days, but for some women the bleeding lasts much longer and can become very heavy.

Menorrhagia or Excessive Bleeding

If you suffer from heavy periods, you are not alone.   More than 20% of menstruating women share this condition, which is most common in women in their 40s and 50s.

When it comes to periods - how long they last, how heavy they are - there is a wide range that is still considered normal.  The average period lasts 5-7 days, and the average amount of blood lost is only one to two ounces—about 1/4th cup-- per cycle.  However, women who suffer from heavy periods may bleed as much as 10 to 25 times that amount each month. 

 If you are one of those women, you probably know what it’s like to experience one or more of these symptoms:

• Periods that last longer than seven days
• Menstrual flow that interferes with your regular activities or lifestyle and causes anxiety about embarrassing accidents
• Menstrual flow that soaks through one or more tampons or pads every hour for several consecutive hours
• Menstrual flow that includes large blood clots
• Fatigue or shortness of breath (which are symptoms of anemia caused by blood loss)

Women who experience a heavy loss of blood each month are at risk of developing anemia, which is a lack of iron in the blood.  It can affect their quality of life by causing symptoms of fatigue, weakness, and even dizziness or fainting spells. 

Your healthcare provider will normally try to control the bleeding using medications.  However, if medications are not effective, a procedure called Thermachoice endometrial ablation may be recommended.

Thermachoice Endometrial Ablation

Ablation is a procedure in which a thin layer of the lining of the uterus, or endometrium, is destroyed, while leaving the rest of the uterus intact.  In many women, this stops all menstrual flow, although some women continue to have regular periods.  Thermachoice endometrial ablation is our recommended method of ablation.  

Thermachoice is a quick (usually less than 30 minutes), simple, and minimally invasive treatment developed to reduce excessive menstrual bleeding without a hospital stay.   Unlike a hysterectomy, this procedure allows you to preserve your uterus, and recovery is fast - many women return to their normal activities the next day.

For some women, the procedure is performed in our office under local anesthesia, but for other women general anesthesia is used and the procedure is performed in the operating room.   A balloon catheter is inserted vaginally, through the cervix and into the uterus.  The balloon is inflated with a small amount of sterile fluid to conform to the shape of the uterus.  This fluid is then heated to approximately 188 degrees Fahrenheit.  This temperature is maintained for eight minutes. 

The heated balloon, in contact with the uterine lining, treats the endometrium, which will slough-off, or shed, over the next 7-10 days.  After the treatment, the balloon is deflated and the balloon catheter is withdrawn and discarded.  

After the Procedure

You can expect to rest under supervised care in outpatient recovery for one to three hours after the procedure.  Although some women experience minimal to no pain or cramping, the majority of patients will experience some moderate cramping during the first day.  Your physician will probably prescribe an anti-inflammatory pain reliever if needed.   Most women are able to resume normal activities by the next day.Also, patients usually experience a small amount of vaginal discharge or spotting, which changes to a watery discharge.  This is a normal part of the healing process and can last for several weeks.

Effectiveness, Side Effects and Risks

Successful treatment results in a reduction of your menstrual flow to normal levels or less.  Eighty-five percent of women can expect light to moderate periods, while others experience a complete elimination of uterine bleeding.  Certain side effects are common after the procedure, including cramping, discharge and frequent urination.   In a small percentage of women, adverse effects such as nausea, vomiting, pain, fever, and infection of the endometrium have been reported. As with any procedure, there are serious risks that are rarely associated with the Thermachoice procedure.  They include possible rupture of the uterus; thermal injury to adjacent tissue;  heated liquid escaping into the vascular spaces and/or cervix, vagina, fallopian tubes, and abdominal cavity; hemorrhage;  infection or sepsis;  perforation;  post-ablation tubal sterilization syndrome;  complications leading to serious injury or death.

When Not to Have the Procedure

Your physician or midwife will not recommend the procedure if you have any of the following medical conditions, so be certain that she or he is aware if you have:

• A current genital or urinary tract infection
• An IUD birth control device currently in place
• A possibility of being pregnant, or a desire to become pregnant in the future

Remember

Thermachoice endometrial ablation is a safe and effective procedure for women with heavy menstrual bleeding.  If you would like more information about the procedure, talk to your healthcare provider or go online to http://www.pelvichealthsolutions.com/thermachoice.