Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Endometrial ablation is the surgical destruction of the lining tissues of the
uterus, known as the
endometrium.
Endometrial ablation is one type of treatment for
abnormal uterine bleeding.
Why is endometrial ablation done?
Endometrial ablation is a treatment for abnormal bleeding of the uterus that
is due to a benign (non-cancerous)
condition. Endometrial ablation is not sufficient for treatment of bleeding due
to cancer of the uterus, since cancer
cells may have grown into the deeper tissues of the uterus and would not be
removed by the procedure.
Endometrial ablation is only performed on a
nonpregnant woman who does not plan to become pregnant in the future. It should
not be performed if the woman has an active
infection of the genital tract.
Endometrial ablation is not a first-line therapy for heavy bleeding and should only be considered when
medical and hormonal therapies have not been sufficient to control the bleeding.
How is endometrial ablation performed?
Prior to the procedure, a woman needs to have an
endometrial sampling (biopsy) performed to exclude the presence of cancer.
Imaging studies and/or direct visualization with a hysteroscope (a lighted
viewing instrument that is inserted to visualize the inside of the uterus) are
necessary to exclude the presence of
uterine polyps or benign tumors (fibroids)
beneath the lining tissues of the uterus. Polyps and fibroids are possible
causes of heavy bleeding that can be simply removed without the need for
ablation of the entire endometrium. Obviously, the possibility of
pregnancy must
be excluded, and intrauterine contraceptive devices (IUDs) must be removed prior to considering
endometrial ablation.
Hormonal therapy may be given in the weeks prior to the procedure
(particularly in younger women), in order to shrink the endometrium to an extent
whereby ablation therapy has the greatest likelihood of success; because the
thinner the endometrium, the greater the chances for successful ablation.
To begin the procedure, the cervical opening is dilated to allow passage of
the instruments into the uterine cavity. Different procedures have been used and
are all similarly effective for destroying the uterine lining tissue. These
include laser beam, electricity, freezing, heating, or microwave energy.
The
choice of procedure depends upon a number of factors, including
The type of anesthesia required depends upon the method used, and
some endometrial ablation procedures can be performed with minimal anesthesia
during an office visit. Others may be performed in an outpatient surgery
department.
Menstrual cramps (pain in the belly and pelvic area) are experienced by women as a result of menses. Menstrual cramps are not the same as premenstrual syndrome (PMS). Menstrual cramps are common, and may be accompanied by headache, nausea, vomiting, constipation, or diarrhea. Severity of menstrual cramp pain varies from woman to woman. Treatment includes OTC or prescription pain relief medication.
Though uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including: over age 50, endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, having colorectal cancer. Symptoms of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding. Causes of abnormal may arise from a variety of conditions.
Uterine fibroids are benign tumors that originate in the uterus and are usually round or semi-round in shape. The most common symptom of a uterine fibroid is abnormal vaginal bleeding. Other symptoms include pressure, pelvic pain, pressure on the bladder, or pain during a bowel movement. Treatment options vary from surgery to medication.
Vaginitis is any type of vaginal infection or inflammation. The six most common types of vaginitis are Candida (yeast infections), bacterial vaginosis, trichomoniasis vaginitis, chlamydia vaginitis, viral vaginitis, and noninfectious vaginitis. Symptoms include itching, burning, and abnormal vaginal discharge. Treatment is different for each type of vaginitis.
Pulmonary edema (swelling or fluid in the lungs) can either be caused by cardiogenic causes (congestive heart failure, heart attacks, abnormal heart valves) or noncardiogenic causes such as ARDS, kidney failure, high altitude, pneumothorax, pleural effusion, aspirin overdose, pulmonary embolism, and infections. The treatment of pulmonary edema depends on the cause of the condition.
Infertility is the diminished ability to conceive a child. The primary cause of infertility in men is a sperm disorder. In women, the primary cause of infertility is an ovulation disorder. Most forms of infertility can be treated. Conventional infertility therapies include drugs or surgery.
Benign uterine growths are tissue enlargements of the female womb (uterus). Three types of benign uterine growths are uterine fibroids, adenomyosis, and uterine polyps. Symptoms include: abdominal pressure, pelvic pain, and pain during intercourse. Diagnosis and treatment of benign uterine growths depends upon the type of growth.
Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Infertility means not being able to get pregnant after one year of trying. Or, six months, if a woman is 35 or older. Women who can get pregnant but are unable to stay pregnant may also be infertile.
Pregnancy is the result of a process that has many steps. To get pregnant:
A woman must release an egg from one of her ovaries (ovulation).
The egg must
go through a Fallopian tube toward the
uterus (womb).
A man's sperm must join
with (fertilize) the egg along the way.
The fertilized egg must attach to the
inside of the uterus (implantation).
Infertility can happen if there are problems with any of these steps.
Is infertility a common problem?
Yes. About 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant, according to the Centers for Diseas...