A "predictable nuisance" is how most women might describe their monthly periods, but for nearly 10 million American women who suffer from menorrhagia, or heavy menstrual bleeding, a period can cause extreme discomfort and wreak havoc on personal and professional lives.

In the past few years, a procedure known as endometrial ablation has emerged as one solution, offering measurable relief to many women suffering from menorrhagia. The outpatient procedure involves removing the lining of the uterus, the source of monthly bleeding, using radio energy delivered via a small handheld device.

"The definition of a heavy period has changed over the years," said Dr. Laura France, an obstetrician and gynecologist at Generations Women's Health Center in Shoreview. "It's no longer relative to a certain amount of blood lost or its duration, but is now applicable to any woman who finds that her period significantly interferes with daily life."
 

France and Dr. James Presthus, an obstetrician and gynecologist in Edina, will discuss menorrhagia and endometrial ablation at the Minneapolis Women's Expo this weekend at the Minneapolis Convention Center.

In the past, treatment options for women have been limited to hormone therapy and the use of oral contraceptives. Birth control pills have always had the hormonal power to stop periods, and a new generation of drugs (Seasonale and Seasonique) allows women to reduce the frequency of periods to four times a year. Another new drug, Lybrel, does away with them completely, but many women involved in testing the drug continued to experience spotting.

Some menorrhagia sufferers elect to have a hysterectomy, which can pose significant health risks and carries a recovery period of two weeks or more.

With ablation, "there are no hormones involved and no device which remains in place," explained France. The actual procedure takes only about 2 minutes. In the days following the ablation, discharge is the most common side effect and can last from two weeks to a month, France said. After this recovery period, 50 to 60 percent of patients report full cessation of monthly periods, while 30 to 40 percent still experience mild periods until they reach menopause.

"What I'll usually hear from those women is that compared to what they were experiencing before, their periods are very manageable," said France, adding that most women who opt for endometrial ablation are satisfied with the results.

Women still in their childbearing years are not candidates for the procedure; most of them must rely on hormone therapy to relieve symptoms as much as possible. "It's also important for younger women to talk to their physicians about their heavy periods to rule out other possible causes for more than a normal amount of bleeding, such as thyroid abnormalities," France said.

The option of endometrial ablation is often a word-of-mouth topic. Many women treated by France are nurses and teachers who simply cannot make time in their busy days to deal with menorrhagia's complications.

"They tell me they talk about the procedure with co-workers because it has made such a difference in their lives," she said. "We want women to be comfortable talking about this and to know there is an effective way to solve the problem."