Comparing Endometrial Ablation and Hysterectomy

If you are living with the menstrual pain and inconvenience of heavy periods, wading through all the different treatment options may be overwhelming. Both endometrial ablation and hysterectomy have been proven effective at relieving menorrhea, what’s commonly called heavy menstrual bleeding. So what are the factors that compel some women to choose one procedure over the other?

Endometrial Ablation for Heavy Bleeding

Endometrial ablation, like hysterectomy, is an option for women who have completed childbearing. This common medical procedure has been proven to either lighten or stop bleeding, while giving women the option of keeping their uterus. When you have a period, the blood that is expelled by your body is the endometrial lining of your uterus. In the endometrial ablation procedure, the endometrial lining is intentionally removed so that bleeding can no longer occur. This treatment for severe bleeding is an outpatient procedure done with a tool called a hysteroscope, a thin tube that illuminates and examines the uterus, along with another device that removes the endometrial lining.

Women who choose endometrial ablation may be interested in trying another option before a hysterectomy or delaying a hysterectomy. Endometrial ablation is considered by some women to be a short-term solution to their heavy bleeding – the procedure sometimes needs to be repeated or may lead to an eventual hysterectomy, but most women find that the treatment to be successful for several years or more. Recovery for endometrial ablation usually occurs within a couple of days and most women are able to return to work much sooner than if they had undergone a hysterectomy. The results of an endometrial ablation may be seen immediately, but most often it may take a few months.

Without the lining of your uterus, it is unlikely that a fertilized egg will be able to implant into your uterus, making it unlikely that you can get pregnant. Post-ablation pregnancy is uncommon, but still possible, and pregnancy after ablation can be risky. Because of this, sexually active premenopausal women should use birth control following an endometrial ablation for heavy periods.

Hysterectomy for Heavy Bleeding

Hysterectomy for heavy menstrual bleeding is a surgical procedure that removes all or part of the uterus. There are a few different types of hysterectomy:

• A partial hysterectomy removes just the upper part of the uterus while leaving the cervix in place.
• Total hysterectomy removes the whole uterus and the cervix.
• Radical hysterectomy removes the whole uterus, the tissue on both sides of the cervix, and the upper part of the vagina. Although a hysterectomy can be done with a minimally invasive procedure, it is still considered a major surgery and requires a surgical incision. Like endometrial ablation, the procedure can be performed in an outpatient setting. The recovery time from minimally invasive hysterectomy is much less than a traditional hysterectomy – most women are able to return back to work in less than one week. Heavy menstrual bleeding is resolved immediately following hysterectomy because the uterus is no longer present to cause periods. This makes hysterectomy the ultimate long-term solution for heavy periods. Following hysterectomy there is no chance of pregnancy.

Content Sponsored by: MIRI Women – The Minimally Invasive Reproductive Surgery Institute (MIRI) brings together highly skilled, board-certified specialists who are focused on women’s health. Our team of professionals is trained in advanced gynecology, specifically hysterectomy surgery. Philosophically, our partner physicians take a “less is more” approach to health care, by first treating patients with the most conservative therapies. MIRI focuses on physical healing, while emphasizing that a patient’s emotional well-being is just as important.