Keep Your Uterine Lining or Do Ablation, What are Some Considerations

Women who have heavy bleeding are told to consider eliminating the uterine lining. The uterine lining is medically called the endometrium, and it is designed to be the lush baby bed. Originally, or as scientists like to say "ontogenetically" shedding the lining in the way of menstrual blood is to keep it fresh and ready for the next pregnancy. But I like to think of those menstrual periods as the first' blue stick' tests we had. We just needed that firm signal once our roles changed from ready to have a baby to baby present. So the lining is shed monthly, it's not destroyed permanently in the 'natural' premenopausal state. Of course we go back far enough in time women didn't actually have many of those shedding episodes at all. Women in cave times had about 20 menstrual cycles in their life, and now we have about 400.
They were pregnant, they were breast feeding, they were malnourished, and no periods. Then physicians came up with a thought. Gynecologists noting that when women after severe infections got scaring and damage that wasn't reversible, modern technology took those lemons and made lemonade! The purposeful creation of a useless lining that would just be scar tissue and not something that could be shed. The technique of ablation takes that shedding a bit farther, it destroys the ability to regenerate. When and why to have the procedure has also evolved.
The surgery can be performed by manually remove the tissue with a rollerball or rollerblade aimed through the hysteroscope and attached to heat. Or other ways of doing the surgery include the NovaSure, the Thermal Choice Balloon, the HydroThermAlate HTA or a cryosurgery device. From women in the past who only had this done as a "last resort" to women having this as their first line treatment for unwanted bleeding. TeLinde's Gynecologic (one of the leading gyno books) text says "there has been significant disagreement regarding the appropriate indications for this procedure," and we'll mull that one over later. Are we trying to say here that women shouldn't have control over their bodies? We wouldn't be hinting that its' actually not up to us to say when to just say NO to your menstrual periods? WWYIC say....(insurance company)? ACOG since their position paper in 2007 says:

Endometrial ablation is indicated for the treatment of menorrhagia or patient-perceived heavy menstrual bleeding in pre-menopausal women with normal endometrial cavities who have no desire for future fertility.
The presence of anemia or failure or intolerance of medical therapy are important considerations but should not be construed as prerequisites for the procedure.

Well, first when you are considering having an ablation, be sure there is no contraindication, like a cancer of the lining, a polyp, or infection. Also some women with polyps and fibroids may be treated with other or additional techniques. And how anemic are you is another consideration before having the procedure. Women with sight anemia will tolerate the surgery well in many cases, severe anemia may need to be treated first. Make sure your pap is current. But after that, lets sit down Gyno to Girl, and Gab.

Post-Endometrial Ablation Syndrome

If you have had an endometrial ablation and have developed symptoms of pelvic pain you might have post endometrial ablation syndrome. What is post-endometrial ablation syndrome? It is a constellation of symptoms due to entrapped blood or tissue within a uterus that has previously undergone an endometrial ablation. We are able to diagnose this at Women's Health Practic e but occasionally other conditions are causing similar symptoms. Other complications of endometrial ablation include pregnancy, risks from pre-existing conditions such as a polyp or fibroid, an infection of the uterus, or a pregnancy. If you have had a tubal ligation then it is possible that the condition could be post-ablation tubal sterilization syndrome. The ablation procedure is designed to destroy all lining tissue, but in fact there is no way to confirm the completeness of the ablation. It is thought that either residual or regrowth of the tissue is producing the symptoms of post-endometrial ablation syndrom...

Passing Your Uterine Lining, Menstrual Period Norms

Decidual Cast Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. Generally the lining of the uterus is only 6-8 mm thick at the time of the menstrual period, and it is shed gradually, a few cells at a time. The decidual cast is when the entire lining passes spontaneously. It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you...

You Have an IUD: But a Positive Pregnancy Test

Fortunately IUD pregnancy failures are rare. But if you have an IUD for contraception, and you get a positive pregnancy test, you probably ask yourself, what next? Well, make your gyno appointment promptly, this is a condition that is not typically an emergency, but it can be and it’s not handled over the phone or on a blog, or through self diagnosis! That being said, some researchers from University of Texas Southwestern Medical Center in Dallas decided to look back at over 4100 women who had IUDs and of those 42 cases who became pregnant in their institution, over about a year period of time, to help understand what these women could expect when they got to their gyno and what actually happened to their pregnancies. Accurate pregnancy diagnosis, pelvic examination, and pelvic ultrasound were the cornerstones of the evaluations. They had very specific ways they looked at their ultrasound to prove there was no pregnancy in the fallopian tube, or partially in the fallopian tube...

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