Abnormal Bleeding

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Evaluation & Management of Abnormal Vaginal Bleeding with Non-Surgical Medical Management when Appropriate

Minimally Invasive –  In Office –  No Incision – Hysteroscopic Ablative Procedures

Endometrial Ablation

Endometrial ablation is a procedure for women suffering from excessive or prolonged menstrual bleeding who have not responded to other treatments and cannot or does not wish to undergo a hysterectomy. Endometrial ablation removes or destroys the uterine lining (endometrium) while leaving the ovaries and actual uterus intact. The endometrium heals by scarring, which reduces or stops future uterine bleeding. Approximately 10-20% of patients require a second procedure or hysterectomy if symptoms reappear after a re-growth of the endometrium.

Different ablation techniques that are used in this procedure include:

  • Laser beam (laser thermal ablation)
  • Electricity
  • Freezing
  • Microwave

Endometrial ablation is a short outpatient treatment and recovery time varies from a few days to six weeks. Symptoms of recovery include cramping, a small amount of watery discharge mixed with blood, frequent urination, or nausea. Because endometrial ablation destroys the lining of the uterus, the procedure is not for women who still wish to become pregnant. Furthermore, women who have a malignancy or pre-malignant condition of the uterus are not candidates.


Manufactured by Gynecare, ThermaChoice® is a minimally invasive alternative treatment for abnormally heavy periods. Like endometrial ablation, ThermaChoice uses heat to destroy the uterine lining and reduce future uterine bleeding, but does so with no incisions or anesthesia. ThermaCare can also eliminate the need for a hysterectomy for women who do not wish to undergo major surgery or have their uterus removed.

During the ThermaChoice procedure, a small, flexible balloon catheter is inserted through the vagina and cervix and into the uterus. The balloon is then filled with a fluid to help it inflate and mold to fit the unique contours of the uterus, and then heated and circulated for 8 minutes to help melt the lining of the uterus. The fluid and balloon are then carefully removed from the uterus, causing no scarring and virtually no discomfort for most patients. Some women may experience feelings of warmth or pressure during the procedure, but these symptoms are typically mild.

After the ThermaChoice procedure, patients will shed the treated uterine lining in the form of a menstrual period about 7 to 10 days after. Patients are able to return to work and other normal activities the day after the procedure, and can return to sexual activity after 7 to 10 days. Some women may continue to experience heavy menstrual bleeding during their next few periods, but most women eventually see their periods return to a more normal state.

Although the ThermaChoice procedure is considered safe, there are certain risks and complications associated with any medical procedure. Some of these may include rupturing of the uterus, thermal injury to uterine tissue, hemorrhaging, infection, perforation and more. Most of these complications are considered rare, and most patients undergo this procedure with little to no problems.

If you are interested in learning more about the ThermaChoice procedure, please contact us today to schedule an appointment.


NovaSure® is a minimally invasive alternative used to treat heavy menstrual bleeding, a condition known as menorrhagia. Menorrhagia is a common condition that affects over 10 million women each year and causes pain, fatigue and other symptoms. Women with menorrhagia have periods that last over 7 days, soak through a tampon or pad every hour and pass blood clots during their period.

NovaSure is an FDA-approved treatment and involves a modified endometrial ablation treatment, but with no incisions, anesthesia or downtime. During the NovaSure procedure, the cervix is dilated and a soft, thin wand is inserted through the vagina and into the uterus. A triangular mesh array is then extended through the wand to contour to the shape of the uterus, before radiofrequency energy is delivered to the area for 90 seconds. The RF energy helps melt and destroy the uterine lining to reduce or even eliminate menstrual bleeding. After the RF energy is applied, the mesh array retracts and is gently removed from the uterus.

The entire NovaSure procedure takes about five minutes to perform and is done in your doctor’s office. Your doctor may apply a local anesthetic to the area to help relieve any discomfort, but it is not needed in most cases. Most women only experience mild cramping and discomfort after the procedure.

After undergoing NovaSure, patients can return to work and other normal activities the very next day. Mild pain medication such as ibuprofen can be taken to relieve any discomfort after the procedure. Some women may experience vaginal discharge or bleeding as well, but these symptoms usually go away on their own within a few days. Up to 97% of women experienced a relief in the menstrual bleeding and related symptoms 12 months after the procedure.

Although the NovaSure treatment is considered safe, there are certain risks involved with any medical procedure. Some of these risks may include thermal injury, perforation, infection or pregnancy complications.

If you are interested in learning more about the NovaSure procedure, please contact us today to schedule a consultation.