What is endometrial ablation?
Many women experience heavy menstrual bleeding at some point in their lives. But for one in four women, every period is heavy. Doctors call this condition “menorrhagia”. Endometrial ablation is one of several possible options used to treat menorrhagia by removal (or “ablation”) of the inner lining of the uterus. The procedure is minimally invasive and usually takes less than an hour. It’s usually done on an outpatient basis, so if you have an endometrial ablation, you’ll most likely be able to return home on the same day.
Endometrial ablation is not recommended for women who:
- suffer from uterine cancer, a pelvic inflammatory disease or an active urinary tract infection
- have certain types of uterine abnormalities
- use an IUD
- intend to become pregnant
- are seeking to use the procedure for contraceptive purposes
What is cryoablation?
For pre-menopausal women who experience menorrhagia and minimal menstrual pain, Dr. Garofalo often recommends an endometrial ablation treatment called Her Option® Cryoablation. This procedure uses a small probe cooled to sub-zero temperatures that is placed into the uterus under ultrasound guidance. The cold temperature removes the inner lining of the uterus. Cryoablation usually causes minimal discomfort and requires a short recovery period. It typically results in a significant decrease in menstrual flow, and in some cases eliminates menstrual periods altogether. Cryoablation is the only endometrial ablation therapy approved for use in a doctor’s office. It does not cause hormonal changes. In some cases, effectiveness may decrease after five years.
Preparing for cryoablation
- Take Motrin as prescribed starting 24 hours prior to the procedure.
- You may eat a light meal prior to your appointment. However, do not eat any food for four hours prior to the procedure.
- You will need to have a full bladder for the procedure so be sure to drink two 8 oz. glasses of water before arriving at the office. Do not empty your bladder prior to the procedure.
- Plan to arrive at the office one hour prior to the procedure so that preoperative medications can be administered.
- You should plan on your appointment taking about two hours. The actual procedure lasts less than 30 minutes but you will need to remain in the office for a short period after the procedure.
- Although most patients are able to drive home after cryoablation, it’s a good idea to arrange for transportation in case you feel uncomfortable.
- One hour prior to the procedure, an injection of a Motrin-like medication will be administered. In addition, a local anesthesia will be injected into the cervix immediately prior to starting the cryoablation.
- A slender probe will be inserted through your vagina into your uterus. The probe is so thin that it requires little or no cervical dilation, minimizing discomfort.
- Once the probe is in place, the cooling process begins. The probe freezes the uterine tissue symmetrically around its tip. After several minutes, Dr. Garoalo will warm the endometrium for one to two minutes and then repeat the freezing.
- After a final brief warming cycle, the procedure is complete.
- You may want to take it easy for the rest of the day. Most women can return to normal activities the following day.
- You will most likely experience mild to moderate cramping (similar to menstrual cramping) and a pinkish watery discharge for up to three weeks after the procedure.
- Take ibuprofen if needed for cramps after the procedure. If adequate pain relief is not obtained with ibuprofen, contact Dr. Garofalo for additional advice. (If you are allergic or intolerant to ibuprofen, acetaminophen can be substituted.)
- Contact Dr. Garofalo if you experience any of the following after surgery: nausea, vomiting, shortness of breath, persistent or increasing pelvic or abdominal pain, fever over 100.4°F or chills, or heavier vaginal bleeding than your normal period.
- During the first several menstrual periods after cryoablation, you may not experience the full eventual reduction in menstrual flow. Continue to keep a careful menstrual record chart.
- A follow-up office visit is recommended three months after the procedure.
Other questions about cryoablation
Will it hurt?
Most women don’t experience pain during cryoablation. You may, however, feel mild pressure or a sensation similar to menstrual cramps. Taking an over-the-counter anti-inflammatory medication or analgesic ahead of time can help reduce discomfort.
What are the risks?
Every medical treatment has risks and complications. Talk to Dr. Garofalo to make sure you understand the potential complications and benefits of cryoablation.
Does my insurance cover the procedure?
Most private insurances cover Her Option® Office Cryoablation Therapy. Be sure to check with your insurer prior to the procedure. In some cases a co-pay is all that’s required.
When will I see results?
Although some women see results immediately, it may take up to three months following the treatment before you experience a reduction in bleeding.
What will my bleeding be like?
The goal of Her Option® Office Cryoablation Therapy is to reduce uterine bleeding to normal levels. Occasionally a woman may stop getting her period altogether after cryoablation therapy, or may experience light spotting for a few days each month.
Will there be any side effects?
Immediately following cryoablation, some women feel cramping similar to a menstrual period. A mild medication like ibuprofen and a heating pad can help minimize discomfort. You may also experience a watery discharge for up to three weeks following the treatment as the tissue heals. This is normal.
Many women who undergo Her Option® Office Cryoablation Therapy report a reduction in PMS symptoms such as fatigue, irritability and cramping.
The treatment should not affect your desire for or enjoyment of sexual activity.
Can I get pregnant after undergoing the procedure?
You should only use Her Option® Office Cryoablation Therapy if you no longer plan to have children. However, it is possible to become pregnant following the therapy. Because such a pregnancy would be high risk, you should continue to use a reliable form of birth control after your treatment.