GynoFiles

A study of the way that both Myosure and NovaSure was used to treat heavy uterine bleeding has been published. The abstract of the article can be accessed here: http://www.reproductivemedicine.com/toc/auto_abstract.php?id=2451 http://www.reproductivemedicine.com/toc/auto_abstract.php?id=24511 1 Women's Health Practice congratulates her on this publication, and thanks to our patients who participated in this work.

endometrial Ablations are for removing the uterine lining in women with heavy menstrual bleeding, and it is used in women with heavy bleeding due to other gynecologic conditions such as uterine fibroids and uterine polyps. Although Ethicon recalled its  Gynecare Thermachoice III Uterine Balloon Therapy System silicone catheter, there are still many choices of devices and techniques for endometrial ablations. The “voluntary recall involves only the catheter component of the Gynecare Thermachoice system they found that stability data does not substantiate the labeled two-year shelf life of the product subject to the recall. There is no significant safety issue with the Thermachoice device.” 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 thi...

The Minerva System has been developed as a new uterine ablation technology to treat women with heavy menstrual periods who also are no longer trying for pregnancy.Previously available uterine ablation technology included NovaSure , balloon procedures, cryotherapy, rollerball ablations, or heated water therapies. NovaSure had out performed all the systems until now the Minerva system has updated the technology of the NovaSure for a better ablation. Causes of heavy periods ore many including problems with the uterus, with the cervix, with medications, with the ovary, and there are bleeding problems of other organs that one may mistake for heavy uterine bleeding (including the urethra, the vagina, the vulva, or the rectum. These problems may be non-cancerous conditions or diseases, infections, cancers,bleeding disorders, nutritional disorders, or problems related to pregnancy. Most often simple testing can help sort out the cause, to see if in fact a woman is eligible for an endometrial...

Often women will walk into our practice stating their periods are so miserable they think they need a hysterectomy , but it's rarely the case that the miserable period not be treated with less extreme measures. Even if you have cancer risk factors, or have a strong family history for hysterectomy, or think you have already failed all the available therapies, there are likely treatments that your gyno will have not yet tried, and it may be worth listening to your choices. Heavy bleeding and dysfunctional bleeding are the two main reasons women consider having a hysterectomy; but evaluating the ways you can avoid hysterectomy is important as well. Some women can take oral contraceptives , others can take Lysteda, but for those done with having children endometrial ablations are an excellent choice. Endometrial ablation for avoiding hysterectomy has been around for several years and more data is being released regarding long term success. At a year, almost 80% of women are either b...

Endometrial ablation technology controls heavy menstrual bleeding but it doesn't provide adequate contraception. If there remains any viable endometrium (uterine lining tissue) then a woman can still get pregnant, thus contraceptive planning at the time of endometrial ablation is very important. Pregnancy after the endometrial ablation is considered dangerous. At least 1/3 pregnancies after an ablation will miscarry, there is a 5 times greater ectopic pregnancy rate, there is up to a 30% risk of premature birth, and there is a 25% risk of the placenta being implanted abnormally. There have been rare reports of uterine rupture during pregnancy and also cases of bands growing in the uterus that can cause several fetal deformities. And the newest MRI studies show that 95% of women with prior endometrial ablation will still have some viable endometrial tissue. Even women who no longer get menstrual cycles will still likely have some small amount of viable uterine lining tissue and h...

Heavy menstrual bleeding can be treated by many therapies,including birth control pills, progesterone, the Mirena IUD, nonsteroidal anti-inflammatory drugs (NSAIDs), and antifibrinolytics.These medicines may be the right therapy for you, but there are reasons that the Office NovaSure treatment may in fact be a better choice for some. It is important for you and your gyno to discuss which will be right for you. Mirena IUD was the best at the treatments.  supported by National Institute of Health Technology Assessment Programme, called the ECLIPSE study which was headed by Dr. Janesh Gupt of the University of Birmingham in England.  The study was then published in the New England Journal of Medicine 1013. In this study the physicians studied heavy menstrual bleeding and most importantly a woman's perception of benefit from their menstrual treatments. They looked at how controlling heavy periods: called menorrhagia, affects six functions of life: practic...

There are women who are bothered by their menstrual periods: and this complaint can be handled in a day. Women who are done having children should consider the option of stopping their heavy periods with the technique called endometrial ablation. For women with heavy menstrual bleeding the period can be here to day and literally gone tomorrow with this treatment. Once a woman has an endometrial ablation, she will almost be sure to never have a heavy period again, although she has to heal and will have some sort of light bleeding or discharge in the healing phase. Over 50% of women will have no periods at all after an endometrial ablation. Another 40% of women formerly with heavy periods will just have very light bleeding during their periods after having and endometrial ablation procedure. Office endometrial ablation is covered by most insurances with just your office copay. You can call today, get an appointment to have an ablation done, and find out what your insurance company wil...

Endometrial Ablation Complications Reported to the FDA in their Manufacturer and User Facility Data Base, as reported by Drs Brown and Blank in the journal Obstetrics and Gynecology, and serious complications are still thought to be rare. Prior to the advent of the minimally invasive devices like the NovaSure or the thermal balloon physicians performed these surgeries by manual laborious techniques and there were complications that we do not see any longer with the newest devices. These physicians evaluated over 800 reported complications of endometrial ablation in 9 categories of use in the years from 2005 to 2011. This type data is kept on all medical devices. The reports are obtained in a variety of ways, hospitals and licensed facilities are required to report any device related deaths or serious injuries, but it’s been noted that these events are under reported. In addition to a hospital or manufacturer reporting difficult cases both physicians and patients can all report compl...

There are various technologies that GynoGab has discussed and been part of research on that are used to get a successful treatment of heavy and painful menstrual bleeding. Before making your final decision, individual consultation is the most important first step. There are often medical or hormonal imbalances that can be fixed before other treatments for instance, your thyroid. Hyperthyroidism, or overactive thyroid is not a common cause of heavy bleeding, about 8% of women with an overactive thyroid will report heavy periods. Hypothyroidism may cause heavy periods, and about a quarter of all women with low thyroid levels will report that their menstrual cycles are abnormal. Once you have determined that there are no medical reasons for the bleeding that can be treated then treating the bleeding is the best option. This can be done with hormone treatments or with surgical options. In some cases a hysterectomy will be indicated.  But for many women today, the best way...

Many women have had an endometrial ablation that worked, and now the bleeding has returned. Womens will report that they may notice this quickly: within a few months of their procedure or it may occur over several months. It is more common to have light periods after a few years than no periods at all after an ablation was done. Many of the women who have had a recurrence of their menstrual woos are contemplating their second procedure. Usually a hysterectomy is not the first choice of treatment when the menstrual cycles recurr after an endometrial ablation, even if the new cycles are painful or have PMS. There are a number of choices of therapies and new ones being developed. For some women, it's time to move on to Mirena IUD, birth control pills, Lysteda or a hysteroscopy with Myosure. And yes, for a small percentage of women hysterectomy should be considered. All these have a roll for some women, and none are the solution for all. For many just repeating the prior NovaSure, o...

 Submucus Fibroid  Fibroid on Ultrasound Uterus Showing Fibroid Interiors These pictures are all of the round muscle knots called uterine fibroids. Usually your physician can feel the fibroids, that are either on the outside of the uterus or ones that make your uterus large, on a pelvic examination. Not every fibroid will need treatment, and we wonder should hysterectomies be done for heavy uterine bleeding with fibroids? Most gynos say most often no a uterine fibroid will not necessarily require surgery, definitely not initially. There are other things to try. And many women haven’t even heard of some of their alternatives for the treatment of these uterine muscle tumors, and there are new ones being developed. Uterine fibroids are the most common gynecologic tumor. And with over 500,000 hysterectomies being done in the USA each year for bleeding, we can actually save a lot of uteri and avoid complications with fewer days out of one’s life if alternatives are eval...

There are several technologies in use today for endometrial ablation, and those in use have been tested and reported as extremely effective. It is up to your gyno, in consultation with you, to select the procedure she or he thinks will be a successful treatment. There are often choices to be weighed, and this short post is not going to cover them all of course! An interesting article was just published in the October journal called Obstetrics and Gynecology by a group headed up by Dr. Penninx from a research medical center in Amsterdam. What they found was that using the bipolar radiofrequency device was more effective than using the hydrotermablation technique. The NovaSure bipolar technique is a wand of relatively set configuration and it is performed "blindly" after insertion. The HydroThermAblator (HTA) is a technique that is performed while still watching with the view of the hysteroscope (telescope seeing in the uterus). The surgeons compared a study that looked at tw...

Women have a lot of choices for control of those periods that are heavy. So if you are suffering from menstrual clotting or severe cramping, or are anemic, it's time to discuss the alternatives with your gyno. There is a medication, you can use birth control pills, you can get an endometrial ablation, or you can get an IUD. In one of the newer studies  on controlling periods with an IUD says that the efficiency of the levonorgestrel-releasing intrauterine system (LNG-IUS) in the management of heavy menstrual bleeding appears to have similar therapeutic effects to that of destroying the lining, or as your gyno would say performing an endometrial ablation up to 2 years after treatment, according to the meta-analysis of 6 randomized clinical trials reported in the April issue of Obstetrics &; Gynecology. One thing is for sure, we have great alternatives to hysterectomies if women present early enough and find a gyno who is familiar with the less invasive treatments. So I incl...

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. Gyneco...