Endometrial Ablation as a Birth Control Method
Endometrial ablation is a procure that destroys or removes the endometrium, which is the lining of the uterus. This procedure can be performed through a number of methods, but the outcome of all is to reduce menstrual flow. Endometrial ablation does affect fertility because it makes the uterus a hostile environment for a fetus, but it should not be used as a birth control method.
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Procedures
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Endometrial ablation is commonly done using a resectoscope. A resectoscope is a type of hysteroscope (a small telescope that can fit through the cervix) with a small wire loop on the end. This loop sends a high-frequency electrical current that can cut and coagulate tissue.
Endometrial ablation can also be done using a new method known as balloon ablation. This procedure inserts a balloon into the uterus and it is filled with hot water. The balloon contains metal electrodes on the outside and when activated the electrical current flows, destroying the endometrial tissue.
Use
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Endometrial ablation is used to treat menorrhagia, which is excessive menstrual bleeding. When the endometrial lining is destroyed, there is nothing for the body to eliminate each month. Most patients see a significant reduction in menstrual bleeding with 50 percent experiencing a lack of any bleeding.
Even though menstrual flow is reduced or eliminated, this does not mean the body is completely infertile. Only patients who are done with child-bearing should consider this procedure.
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Risks
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For some patients, endometrial ablation is a viable alternative to more invasive and risky procedures such as a hysterectomy. Endometrial ablation is an outpatient procedure and most women are back to their normal level of activity within two days. The procedure can cause some uterine cramping and discomfort as well as nausea following the procedure, but these side effects will resolve in a day or two.
The largest risk associated with endometrial ablation is uterine perforation, which is a hole in the uterine wall. Although rare, this is potentially dangerous.
Long term
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Because endometrial ablation destroys both the basal (underlying) layer and the functional layer (the layer that is shed during menstruation) of the endometrium, it is used as a long-term treatment for excessive menstrual bleeding. However, over time, some patients experience a return of their menstrual bleeding, which indicates either an incomplete removal of tissue or a regrowth of endometrial tissue.
Fertility
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There are many factors that affect a woman's fertility. The condition of her eggs, the structure of the fallopian tubes, the environment of the uterus, and her hormone balance are all important for getting pregnant and carrying a baby to term. Interruption in any of these can cause infertility. Although endometrial ablation changes the environment of the uterus, the technique is not recommended for use as a birth control method. The chance of incomplete ablation and the regrowth of tissue make it too uncertain to provide effective birth control.
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