Menstrual bleeding treatment effective in all women

Endometrial ablation, a treatment for excessive menstrual bleeding or “menorrhagia,” appears to be effective in all women, including those who use blood thinners or have underlying bleeding disorders, new research suggests.

Endometrial ablation works by destroying the lining of the uterus with heat, electricity or freezing. Numerous reports have shown endometrial ablation to be useful in treating menorrhagia, even severe forms, in the general population, but relatively few studies have looked at its use in women with disorders, such as thrombocytopenia or von Willebrand disease, that make them prone to bleeding.

To investigate, Dr. Abimbola O. Famuyide and colleagues, from the Mayo Clinic in Rochester, Minnesota, studied the outcomes of endometrial ablation in a reference group of 111 women and in 34 women receiving the blood thinner warfarin (Coumadin) and 7 with blood disorders.

The new findings appear in the journal Obstetrics and Gynecology.

The subjects underwent the procedure at the researchers’ center between 1995 and 2005. The characteristics of the two groups prior to treatment were comparable, the report indicates.

The rates of hysterectomy or the need to repeat the procedure in the groups were similar: 5 percent in the blood disorders group and 7 percent in the reference group.

The time to treatment failure was also not significantly different in the groups. Procedure-related complications were uncommon, generally minor, and occurred with similar frequency in each group.

This is the first and largest study to address the use of endometrial ablation in a growing population of high-risk women with excessive menstrual bleeding or bleeding disorders, the authors conclude. “Endometrial ablation appears to be an effective treatment option for these women.

SOURCE: Obstetrics and Gynecology, June 2007.

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