# Endometrial Ablation Vs. Hysterectomy



## SecondTime'Round (Jan 15, 2015)

I accompanied my sis tonight to her GYN "test results" appointment at her request to help her make a decision about an ablation or a hysterectomy. 

Without giving specifics of her symptoms (not that it's private, just don't want to taint responses), if you've had either an ablation or chose a hysterectomy over an ablation, could you share your experiences? (FYI Hysterectomy would be via a lap and she is almost 43; ovaries would be preserved).


----------



## Woodchuck (Nov 1, 2012)

SecondTime'Round said:


> I accompanied my sis tonight to her GYN "test results" appointment at her request to help her make a decision about an ablation or a hysterectomy.
> 
> Without giving specifics of her symptoms (not that it's private, just don't want to taint responses), if you've had either an ablation or chose a hysterectomy over an ablation, could you share your experiences? (FYI Hysterectomy would be via a lap and she is almost 43; ovaries would be preserved).


The endometrial ablation is less invasive, and has a lower risk of infection. Some insurance companies may require a tubal ligation, to remove the risk of a post ablation pregnancy. A hysterectomy is more invasive, may require a short hospital stay, but is a permanent cure for fibroids, endometriosis, etc...


----------



## NobodySpecial (Nov 22, 2013)

Knowing now what I did not know then, hysterectomy. But the nature of my symptoms were such that nothing else solved. it. Best thing I ever did. But how could I have known the other procedures would not solve the issue? I guess I couldn't.


----------



## NobodySpecial (Nov 22, 2013)

PM me if you want details.


----------



## Woodchuck (Nov 1, 2012)

NobodySpecial said:


> Knowing now what I did not know then, hysterectomy. But the nature of my symptoms were such that nothing else solved. it. Best thing I ever did. But how could I have known the other procedures would not solve the issue? I guess I couldn't.


It is usually best to go with the least invasive procedure unless the condition is life threatening, or unless there would be a great deal of debt incurred if a second, more invasive procedure was later required. You acted with the best intentions and luck was not with you this time. I am glad you eventually got relief from your illness...good health and good luck...:smile2:


----------



## kristin2349 (Sep 12, 2013)

STR, I wanted to avoid a hysterectomy and the resulting surgical menopause. I had an ablation done and it went well, and worked. The surgery was pretty easy and recovery time was much less than a hysterectomy would have been. 

Have your sister ask her Dr. for an iron panel with ferritin levels. I got so anemic before my surgery I ended up really ill and had to get iron infusions, it has taken more than a year to get back to feeling normal (and as a bonus your hair can fall out).


----------



## Rowan (Apr 3, 2012)

My doctor and I were planning for an ablation when she also found a solid, and growing, mass on one of my ovaries. Since that had to be removed as well, we decided to just go ahead with a hysterectomy instead. An ablation wasn't guaranteed to eliminate all of my problems. I didn't think it made sense to try it, and risk having to go back for a hysterectomy later, when I was already going to be having the ovary removed anyway.

My surgery was laparoscopic. I went in at 7:00 and was home by 4:00 that same afternoon. The first few days were pretty rough, but I was able to go back to work full-time at about two weeks, though I was careful not to push myself too hard. I was fully back to normal in about 6 weeks and felt great at about the 2 month mark. 

I'm glad I chose to go ahead with the hysterectomy, but it's not the best option for everyone. If the ablation has a good chance of resolving your sister's issues, it's definitely worth trying unless there are other complicating factors.


----------



## NobodySpecial (Nov 22, 2013)

kristin2349 said:


> STR, I wanted to avoid a hysterectomy and the resulting surgical menopause.


For what it is worth, if she keeps her ovaries, as I did, there is no surgical menopause.


----------



## Fozzy (Jul 20, 2013)

My wife has been toying with ablation for a while. Are there any downsides to it? She's already had tubal ligation so that's not an issue.


----------



## NobodySpecial (Nov 22, 2013)

Fozzy said:


> My wife has been toying with ablation for a while. Are there any downsides to it? She's already had tubal ligation so that's not an issue.


What is the ablation for?


----------



## Fozzy (Jul 20, 2013)

Her doctor mentioned it as a treatment for extremely heavy menstrual bleeding.


----------



## NobodySpecial (Nov 22, 2013)

Fozzy said:


> Her doctor mentioned it as a treatment for extremely heavy menstrual bleeding.


Yah the thing is you never get to know in advance if it is going to work/help. It did not for me. Would have been better to skip to the hysterectomy. But who could have known that in advance, right? 

Good luck to your wife!


----------



## kristin2349 (Sep 12, 2013)

Fozzy said:


> Her doctor mentioned it as a treatment for extremely heavy menstrual bleeding.



It worked for me 100% I am really glad I did it. Like I said to STR, I would recommend any woman who has heavy bleeding get an iron panel run. Treating mine after it became "critical" has been pretty horrible and debilitating.


----------



## Fozzy (Jul 20, 2013)

Yeah, she's already taking iron supplements. She was full-on anemic.


----------



## Annie123 (Apr 27, 2015)

Fozzy said:


> Her doctor mentioned it as a treatment for extremely heavy menstrual bleeding.


I had the same problem for a long time. Endometriosis cost me one ovary. I used to bleed for anywhere from 2 to 6 weeks at a time. BC pills didn't help, they only made it worse. Iron supplements weren't helping much as I was losing blood non stop. Ablation was suggested. But then my doctor decided to have my TSH levels checked and my TSH was over 9. She couldn't believe it was that bad without me even knowing that I had hypothyroidism. She put me on Levothyroxin and guess what? After one month my heavy and prolonged bleeding stopped. Not saying that this is your sister's case too, just saying that maybe other things can be done before doing something as drastic as ablation. Hormones are the worst!


----------



## SecondTime'Round (Jan 15, 2015)

Annie123 said:


> I had the same problem for a long time. Endometriosis cost me one ovary. I used to bleed for anywhere from 2 to 6 weeks at a time. BC pills didn't help, they only made it worse. Iron supplements weren't helping much as I was losing blood non stop. Ablation was suggested. But then my doctor decided to have my TSH levels checked and my TSH was over 9. She couldn't believe it was that bad without me even knowing that I had hypothyroidism. She put me on Levothyroxin and guess what? After one month my heavy and prolonged bleeding stopped. Not saying that this is your sister's case too, just saying that maybe other things can be done before doing something as drastic as ablation. Hormones are the worst!


Her thyroid was slightly elevated, but that's not something we talked about at her appointment the other night. I will mention that to her.


----------



## Fozzy (Jul 20, 2013)

Annie123 said:


> I had the same problem for a long time. Endometriosis cost me one ovary. I used to bleed for anywhere from 2 to 6 weeks at a time. BC pills didn't help, they only made it worse. Iron supplements weren't helping much as I was losing blood non stop. Ablation was suggested. But then my doctor decided to have my TSH levels checked and my TSH was over 9. She couldn't believe it was that bad without me even knowing that I had hypothyroidism. She put me on Levothyroxin and guess what? After one month my heavy and prolonged bleeding stopped. Not saying that this is your sister's case too, just saying that maybe other things can be done before doing something as drastic as ablation. Hormones are the worst!


Good tip. She's actually already on Levo and her levels are stable. It's not endometriosis, she's pretty regular--just very heavy flow.


----------



## SecondTime'Round (Jan 15, 2015)

Fozzy said:


> Her doctor mentioned it as a treatment for extremely heavy menstrual bleeding.


She really should have at least an endometrial biopsy and hysteroscopy (or D&C) before deciding. If she has hyperplasia with atypical cells, she should not have the ablation and should have a hysterectomy (if she's trying to decide). Actually, from what I've read, even if atypical cells are not found with the biopsy and hysteroscopy, they could still be there. My sister's test did not show hyperplasia, although she had misunderstood that before her appointment and thought she did have that. She has endometriosis but she's known that for many years.


----------



## Annie123 (Apr 27, 2015)

Fozzy said:


> Good tip. She's actually already on Levo and her levels are stable. It's not endometriosis, she's pretty regular--just very heavy flow.


I read somewhere that the only way to diagnose endometriosis is through laparotomy or laparoscopy, that it can't be diagnosed without examining endometrial tissue. Not sure if I'm right though. In my case, biopsy showed endometriosis. 
The say one of the main causes of heavy menstrual bleeding is hormonal imbalance. Excessive estrogen or insufficient progesterone.


----------



## SecondTime'Round (Jan 15, 2015)

Annie123 said:


> I read somewhere that the only way to diagnose endometriosis is through laparotomy or laparoscopy, that it can't be diagnosed without examining endometrial tissue. Not sure if I'm right though. In my case, biopsy showed endometriosis.
> The say one of the main causes of heavy menstrual bleeding is hormonal imbalance. Excessive estrogen or insufficient progesterone.


Unless things have changed since I was diagnosed more than 15 years ago, you are correct. I had to have a laparoscopy.


----------



## Anonymous07 (Aug 4, 2012)

Annie123 said:


> I read somewhere that the only way to diagnose endometriosis is through laparotomy or laparoscopy, that it can't be diagnosed without examining endometrial tissue. Not sure if I'm right though. In my case, biopsy showed endometriosis.
> The say one of the main causes of heavy menstrual bleeding is hormonal imbalance. Excessive estrogen or insufficient progesterone.


Yes, you are correct. The only way to diagnose endometriosis is through laproscopic surgery to check. I have endometriosis and was diagnosed at 17. I've had 2 procedures to "clear" it up, but I still have issues with it.


----------



## Anonymous07 (Aug 4, 2012)

SecondTime'Round said:


> I accompanied my sis tonight to her GYN "test results" appointment at her request to help her make a decision about an ablation or a hysterectomy.
> 
> Without giving specifics of her symptoms (not that it's private, just don't want to taint responses), if you've had either an ablation or chose a hysterectomy over an ablation, could you share your experiences? (FYI Hysterectomy would be via a lap and she is almost 43; ovaries would be preserved).


Both have pros and cons, and it really depends on exactly what her issues are to figure out which may work better. Typically, I would always suggest to go the least invasive route first(ablation), but it still depends on what she is having problems with. If she's dealing with severe endometeriosis, I would suggest a hysterectomy. I would not waste time with ablation because the success rate is too low. If it's a bleeding issue, a few tests first and then ablation would probably be better. If something else, the suggestion depends on what it is.


----------



## PieceOfSky (Apr 7, 2013)

My wife had an ablation 8 years ago or so. I don't recall her ever considering a hysterectomy; maybe the doctor steered her towards the ablation (that particular doc has always seemed pushy and impatient to us both).



Iirc, the problem was painful heavy bleeding and thought to be fibroids. I'm thinking an ultrasound was involved in diagnosis.



As surgeries go, it seemed that one was relatively quick and recovery relatively mild for her.



There have been no complications that I am aware of. No signs of endometriosis.



The Dr. warned us to avoid pregnancy. I think such can be life threatening -- not sure I remember that correctly.


----------

