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[Lucille]

I'd be interested to hear your experience with ablation. How quick was your recovery, how effective was it at stopping bleeding, any long term side effects?

[Snowcat]

Hi Lucille.  I can help with this one. I had an endometrial ablation as an alternative to hysterectomy in 2012.  It was fine.  Done under GA and recovery was easy - just some bleeding and cramping, but nothing awful. Just like period pains but not for long. Paracetamol was all
I needed.

 I had lots of post menopausal bleeding beforehand and had several polyps removed.  Gynaecologist said it would solve all that and it certainly has.  No bleeding or pain since and he said that there’s a good chance the endometrium won’t grow back, which suits me as it was a problem as I had hyperplasia too.  As I say, recovery was fine - just a couple of days rest really.  I’m really pleased I had it done.  Hope this helps.

[bombsh3ll]

I personally would seek to avoid an ablation given the multiple medical options for bleed control - amenorrhea or almost complete amenorrhoea can be achieved medically in probably above 90% of patients.

Ablation is starting to fall out of favour because it can result in a lot of scar tissue and adhesions in the uterus, meaning that any future bleeding that occurs is very difficult to investigate.

If it were me and medical treatment hadn't worked or not been tolerated I would consider a hysterectomy instead which gets you permanently off the hook for progestogen treatment.

[Lucille]

Thank you both. I appreciate your replies. Two completely opposite points of view!
I have an appointment next week and am no further forward in making a decision 😅

[JKS]

I had ablation back in 2019 for fibroids & the results were amazing - for the first time in decades I was pain free. I didn't realise how much pain & discomfort I'd been in until the day after surgery, when I realised I wasn't in pain. It had been 'normal' for me to have continuous pain.

The op was straightforward, day surgery, & I recovered quickly. Minimal bleeding & no pain.

It did lessen my periods a little, but not as much as I'd hoped.

Sadly 6 months later the pain was back, so I had another vaginal ultrasound, which showed plenty of fibroids & I was scheduled for a second ablation. I was told that a second procedure was necessary in about 1/3 patients (I assume that's for women who had ablation specifically for fibroids) Then the pandemic hit, my op was cancelled. I'd moved from England to Wales & trying to get a GP appointment was difficult - I was told I was too old for a referral for another ablation, as by the time I got to the top of the waiting list, I'd be post-menopausal & the pain would be gone. I was refused a referral.

Roll on 5 years - still not post menopausal, still in pain from fibroids, although either the pain really is diminishing or it's become normal again. Even harder to get a GP appointment!

Tranexamic acid is contraindicated for me, so that wasn't an option. I had used it successfully for several months before I questioned my GP, who hurriedly took me off it.

[bombsh3ll]

That's awful. You might have missed the boat for a second ablation by the time you are seen but you could still join the wait list for a hysterectomy.

I would emphasize pressure symptoms rather than bleeding, as you will still have fibroids even after your periods stop.

Primary care management, which appears to have been simply telling you that that you can't take tranexamic acid, has been ineffective, and you are entitled to a gynaecology opinion on this basis.

You should at the very least be offered oral progestin therapy for menstrual suppression. Periods have been optional for many decades and nobody needs to live like that.