Several doctors too have raised concerns about the lack of studies in younger populations for this particular procedure.
Painful periods and heavy bleeding cause many women years of discomfort, affecting their day-to-day life and productivity at work.
Dysmenorrhea, the medical term for painful menstrual cycles; and Menorrhagia, the term for abnormally long and heavy bleeding, can happen to anyone with a uterus. But those with higher risk include people who smoke and drink, those who are overweight, those who started their menstrual cycles before the age of 11, and people who have never been pregnant, according to Johns Hopkins Medicine.
Treatment options can include nonsteroidal anti-inflammatory medications, such as aspirin and ibuprofen to reduce pain, oral contraceptives to inhibit ovulation, hormonal treatments, vitamin supplements, and diet changes.
However, in recent days, a new “quick fix” has been catching the attention of many—Endometrial ablation. It is a minimally invasive surgical procedure in which the lining of the uterus, called endometrium, is destroyed to reduce menstrual flow. In some, the flow may stop altogether.
Tools to achieve this are many, and methods might include extreme cold, heated fluids, microwave energy, or high-energy radiofrequencies, the Mayo Clinic says. However, it is not a commonly prescribed procedure because success rates may vary and doctors have to be careful with selecting candidates who would benefit from it. Sometimes social biases can creep into the procedure—an argument laid by activists who claim that a need to keep up fertility prevents many doctors from suggesting the procedure.
"I stopped ... over personal concerns about treatment failures," Linda Bradley told MedPage Today in 2020. She is the medical director of the American Association of Gynecologic Laparoscopists, and no longer performs endometrial ablation. "I think there are better ways to manage abnormal bleeding for the majority of patients," said Bradley, who practices at the Cleveland Clinic.
Several doctors in the United States have echoed Bradley’s concerns in avoiding the procedure of recommending it to patients, citing the failure of the procedure in 6-8 months—the most significant being ablation failure, where severe pain is experienced due to endometrial regrowth and blood trapped under scar tissue.
"I think we've become more complacent when it comes to performing these procedures in recent years because of the notion that it's least-invasive [and] can be done in an office setting, and doesn't have that much downside," said Ali Ghomi, MD, of Sisters of Charity Hospital in Buffalo Ghomi.
"I think we have to revisit ... the nature of the procedure" and it's potential for adverse effects, he said. Several other doctors too have raised concerns about the lack of studies in younger populations.
Hologic, a company working around women’s health, has a procedure called NovaSure which is one of the leading options available for endometrial ablation, according to MedPage Today. NovaSure is estimated to have at least 60% of the endometrial ablation market.
Its website states that the procedure is for premenopausal women with heavy periods due to benign causes who have finished childbearing. It warns that pregnancy following the procedure can be “dangerous,” recommending that it is not for those who have or suspect uterine cancer, an active genital, urinary, or pelvic infection, or an IUD currently in place.
Endometrial ablation has been seen as a way to reduce the number of hysterectomies in the United States, MedPage Today says in its deep dive into endometrial ablation.
But several patients interviewed by MedPage Today, who had severe complications following endometrial ablation, have hinted that they were never fully informed about the risks from the procedure and questioned if such a procedure was necessary for ‘nuisance’ bleeding. Several options can be the first line of treatment before surgical procedures are considered.
There are many options available to doctors to treat Dysmenorrhea, Menorrhagia, and other uterine complications. Before choosing an option, it is advised to understand all the complications and side effects that may occur due to a particular procedure.
References:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/dysmenorrhea
https://www.mayoclinic.org/tests-procedures/endometrial-ablation/about/pac-20393932
https://www.medpagetoday.com/special-reports/exclusives/85088
https://gynsurgicalsolutions.com/patients/novasure/benefits-risks/
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Disclaimer : This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
