Excessive menstrual bleeding falls into the “irregular period” category. While the amount of blood shed by the endometrial lining during a woman’s period varies from person to person, excessive bleeding is different.
Most women occasionally experience a heavy or excessive flow, but chronically heavy periods should be evaluated and discussed with your OB/GYN. If first-line treatments don’t work, a minimally invasive procedure called endometrial ablation can provide long-term relief. However, the treatment renders you unable to bear children – despite being fertile – so it requires careful consideration before proceeding.
Do You Experience Heavy to Excessive Periods?
Your gynecologist is likely to confirm that you experience heavier-than-normal to excessive periods (clinically named menorrhagia) if:
- Bleeding (beyond start-up and fade-out spotting) lasts longer than eight days.
- You soak through more than one tampon or pad every hour for several hours in a row.
- You need to wear more than one super-absorptive pad at a time to handle the flow.
- Periods are so heavy that you must wake up and change pads/tampons at night.
- Your menstrual flow frequently contains clots that are the size of a quarter or larger.
In some cases, heavy periods like this are a sign of endometriosis, PCOS, or fibroid tumors, so we’ll perform exams and tests to determine whether they might be the cause.
Depending on your health history and preferences, we’ll start trying treatments like hormonal birth control, which is often successful and regulates a woman’s menstrual cycle and flow. This is the preferred method of treating excessive period flow for women who plan to have children or continue growing their families.
Your doctor may also discuss the temporary use of gonadotropin-releasing hormone to shrink fibroids, or a prescription medication called tranexamic acid, which is taken at the beginning of your period each month and may reduce bleeding.
Using Endometrial Ablation to Treat Excessive Period Bleeding
Endometrial ablation is considered minimally invasive because we do not use surgical incisions. Instead, we use a specialized, wand-like device inserted through the vagina and dilated cervix to destroy the uterine lining (endometrium).
Our clinic performs this procedure in the hospital. Multiple methods are used to eliminate the lining, such as extreme cold to freeze the lining, heated fluids, electricity, microwave energy, or high-energy radio frequencies. The location and the method for eliminating the lining depend on your health history, the reason for the ablation, and other factors.
The procedure only takes about 10 to 20 minutes. You’ll need a family member or friend to drive you home after the procedure. Plan to take it easy for at least a few days, during which you may experience:
- Slight nausea for the first day as the sedative wears off.
- Abdominal/pelvic discomfort (like period cramps).
- More frequent need to urinate.
- Spotting and bleeding – similar to getting your period. This is usually the heaviest around Day 2 or 3 after the procedure and indicates the rest of the lining is leaving the uterus.
It’s best to schedule the procedure when you have a few days off and can take it easy. You’ll need to use pads (rather than a tampon or any other period solutions requiring insertion) and refrain from douching for a week to minimize infection risks.
You Are NOT a Candidate for Endometrial Ablation If…
Not everyone is a good candidate for endometrial ablation because it is a permanent step that cannot be undone or reversed.
Your doctor should never recommend endometrial ablation to treat heavy menstrual bleeding if:
You are of childbearing age and may want to have children.
This process renders you infertile. In the rare cases that a woman conceives after an endometrial ablation, her risk of pregnancy complications is very high. Even if you are in your late 20s and early 30s and are sure you don’t want children, your doctor may still work to find other treatment methods, as you could change your mind about family building down the road.
You have any opposition to using birth control.
You’ll still ovulate after the procedure, and small areas of endometrial lining can remain. This puts you and the baby at risk, including a much higher risk of miscarriage. Women must use birth control 100% of the time after endometrial ablation until they have officially reached menopause. The best-case scenario is having a partner willing to get a vasectomy to make pregnancy virtually impossible.
You are in menopause or have a history of uterine issues.
Uterine ablation elevates the risk of uterine cancer, especially for women with a history of uterine problems (infections, uterine disorders, etc).
Schedule a Consultation with Northwest Women’s Clinic to Discuss Your Options
Are you tired of the heavy bleeding associated with your periods? Are you interested in learning more about whether endometrial ablation is right for you? Schedule a consultation with Northwest Women’s Clinic for an accurate diagnosis and a mindful discussion of your treatment options.
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