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Firsthand information about endometrial ablation

Anonymous — Mon, 10 Aug 2009 15:19:23 -0800

Please tell me what you know about endometrial ablation as a means of lessening or hopefully stopping my bleeding. (This is a female-parts question.) I'm looking for firsthand information on this procedure, if possible. I have only seen it mentioned a few times in a couple of threads from several years ago. I have Googled and gotten a pretty good idea of the mechanics of the procedure and how it's performed; what I'm looking for is personal experiences, info on whether I'd even be considered a candidate for it, that sort of thing.

I'm a single woman in my mid-thirties, live in the southern United States, casually sexually active, with no children and no desire for them, ever. I have had two abortions in the past. I only reveal this to really drive the point home that I do not want kids and will not be changing my mind.

Ever since I got my first period, my menstrual cycles were unpredictable, prolonged, heavy, and incredibly painful. When I was about 21, my doctor told me about Depo-Provera and I started using it (this was several years before the bone-loss issues were widely known). I was on Depo off and on for about ten years or so (got pregnant and had my second abortion during one of the "off" years). I absolutely loved the complete lack of bleeding while I was on Depo.

Unfortunately, last year I had a bone scan and was diagnosed with severe osteopenia (just shy of having actual osteoporosis), so my GYN insisted that I get off the Depo immediately and she put me on Sprintec birth control pills, to be taken continuously. I was aware that I probably wouldn't be completely bleed-free anymore, but I only expected occasional "spotting." After six months on the Sprintec (presumably the Depo had finally worn off) I started bleeding and didn't stop for a month and a half. Then I took a week off the pills (the "placebo" week, the way BC pills are normally taken, and on the recommendation of the GYN), stopped bleeding briefly, and then started bleeding again. Not monsoon-strength bleeding, but just enough to inconvenience me and constantly make me highly uncomfortable. I was pretty freaked out and expressed my concerns to the GYN, wondering if something might be wrong with me.

Without having me come in to see her, the GYN then switched my prescription to the lower-dose Lessina birth control pills, which I've been on for four months now. For the first three months there was just a little spotting, but now once again I'm bleeding constantly, with all the attendant discomforts (cramping, irritability, etc.) of a real period. I tried taking a week off, again, and the bleeding briefly stopped, but as soon as I got back on the pills I again started bleeding just enough to need tampons. To be clear, the bleeding is not what I think most people would consider "heavy," i.e., needing to change my tampon every hour, but it is constant (not stopping). I am taking the pills as directed, faithfully at at the same time every morning.

The last time I spoke to my GYN about all this, she told me dismissively that "every woman has to deal with some bleeding" and pretty much told me I should get over myself. I won't be going back to her. I'm not a moron and I don't want a doctor who only tells me what I want to hear, but I expect my doctors to be a little kinder when I'm freaking out about my body acting up.

When I find a new GYN, I will of course tell them everything and agree to any tests they might want to run. But I'd like to bring up the subject of endometrial ablation, which I didn't know about until recently and which I've been Googling and reading about, but I don't know anyone in real life who has undergone the procedure. Can any of you provide firsthand information? Will any doctor just refuse me outright if I ask about it? I am still relatively young and have no kids, and I keep reading stories about how doctors won't agree to sterilization procedures on younger people with no kids unless there's a serious enough medical condition to warrant it, and are always assuming a woman will inevitably change her mind later about wanting babies (about which, see above; I really won't).

I also have never been diagnosed with endometriosis, fibroids, cysts, or anything serious like that. My last few PAP tests have been completely normal, though I have not yet had one since going off the Depo last year. There is a history of breast cancer in my immediate family so I'm probably at a higher risk there. Would my current condition be considered "not bad enough" to justify a procedure like this?

Other things I've considered: The Mirena IUD, which was mentioned by my last GYN as an option (but not at the top of her list, since she said I need the estrogen in BC pills to help build my bones back up), but I really don't want to use an IUD. I have read up a lot on those, including many comments here on AskMe, and I know they're now considered very safe and effective, but for personal reasons that's not an option for me. I've also, in desperation, thought about begging to go back on the Depo and take some sort of calcium-building supplement at the same time, but I'm almost certain no doctor would agree to that, knowing what terrible shape my bones are already in.

I will follow up via the mods if necessary, but just to be clear, what I'm really looking for here is firsthand information about endometrial ablation, like, "I/my sister/my friend had the procedure and it was [a big help/a disaster/whatever]," or "I work at a GYN office and you [would/wouldn't] be considered a candidate because [whatever]. You would have to [ask nicely/get off the pills/bleed harder/have a baby/wait a year/whatever] before they would perform this on you."

I know that there is no guarantee it would completely stop my bleeding.

P.S., Any idea how much it would cost, assuming no insurance?

it's a LEEP year!!!

Anonymous — Mon, 02 Mar 2009 10:04:43 -0800

I decided on my obgyn last minute, when the one I wanted wasnt taking new patients. My pap came back abnormal and I had to have a biopsy. They found I have moderate cervical dysplasia. I am scheduled to get a LEEP procedure. I do not like my current obgyn and scheduled an appointment with a new one to get a second opinion. I will have to wait nearly a month to see her and then even longer to have the LEEP performed, if need be. Soooo, what are some experiences with waiting? Should I do it, or go ahead and have the LEEP? I have heard others wait and the abnormalities go away, but I'm not sure how wise this is with "moderate" cervical dysplasia? My current obgyn is cold and scary. I have not met my new obgyn but her reviews are wonderful and she is all about natural birth and other things that sound promising for me....

Oh, doctor!*

miss lynnster — Fri, 19 Dec 2008 16:49:42 -0800

Need to find a *great* GP doctor (and also an OB/GYN if you have one) in Los Angeles. Preferably someone nice who is knowledgeable and interested in finding causes and solutions instead of just masking symptoms. I have had a great dentist and a great dermatologist here for years, but I've never found the right doctors for general stuff or to oversee the health of my ladyparts. I've always commuted to my family doctor in San Diego and I need to quit doing that. It's ridiculous. Soooo, recommendations?

I live near Sherman Oaks, but I'd be willing to drive over the hill. I have Blue Shield PPO.

*Just showin' a little of my San Diego heritage, there. :)

What purpose is served by my ob-gyn inserting his finger in my ass during a pap smear?

Anonymous — Wed, 15 Aug 2007 14:37:01 -0800

I went to a new doctor on a recommendation from a friend to get Implemnon (sp?). The ob-gyn performed a pap smear (it's been a year since my last one). At the end of it, he stuck his finger in my ass -- he was feeling my belly at the same time. Why did he do it?

Help me deal with my condescending doctor!

u.n. owen — Wed, 16 Feb 2005 09:59:31 -0800

Need help with a condescending doctor. This may be girls-only so if you have a problem with words like "ovaries," goodbye. It also involves my being a fat girl, so if you have the HURF DURF BUTTER EATER attitude, goodbye as well. [a lot mi] I recently moved and got new health insurance, and with that a new gynecologist. This was a weird step for me, as the only gynecologist I'd ever had before was the guy who delivered me as an infant. My old doc was fabulous and actually diagnosed me with PCOS (at a time when it was tremendously underdiagnosed) and helped me quite a bit with that.

Now, the new guy, I just went in to see for a Depo shot. No exam needed, I had one three months ago.

The moment I walked in, the man started with the judgments. He took my weight (I weigh about 250, I'm six feet tall, I've maintained this weight for roughly 3 years), then instantly launched into a diatribe on how I needed to lose weight. He recommended both a low-carbohydrate diet and skipping meals(!).

I patiently explained to him that in addition to the PCOS, I have exercise induced migraines, and have for well over a decade. They've done all the tests to make sure it's not a brain tumor or something else like that. I haven't "grown out of them." Exercising regularly doesn't get rid of them, it just puts me into constant misery.

I also told him that I walk 2 miles a day (1 mile to and from work) every weekday, and I figured that's more exercise than most people get.

His recommendation? "Increase that to about two hours of exercise a day by exercising for 45 minutes before you leave for work and 45 minutes after you get home."

Then he launched into the dietary stuff. "Stop eating beef!" he said. "eat more fish and chicken. No fast food."

I contemplated this, then told him I hadn't eaten beef in over a month, and had eaten broiled fish (which I enjoy, especially living here on the gulf coast where it's fresh!) three times in the week. He's like "oh, but I'm sure you're eating a lot of candy and junk food." Uh, no. Sorry, doc. The closest thing to junk food in my house at the time (I've received valentine's chocolate since!) was Terra sweet potato chips. Strike two.

Then, he started to tell me that I should "know my own body" and that it was surely my lack of awareness of my own exercise and diet that was causing my weight issues. I'm thinking, I've lived in my body for a good 20 years. I know it pretty well. You've known me for 45 minutes. What gives?

So AFTER he'd lectured me for literally an hour, talking about how I'd inevitably develop diabetes and such unless I followed all his recommendations and that I probably had never really looked at my food intake, he THEN took my blood pressure. It came out at 138/89, at which point he said "See? Your blood pressure is already elevated beyond what it's been in your other checkups in the last year. Obviously the weight is contributing to poor health."

I wasn't sure what good sputtering at him would do. I felt patronized and like I was about a foot tall. No matter what I told him about my body - or even what the medical records said - he didn't listen and just kept on going.

Here's what I want to know.

1) Am I right to be really frustrated/upset by this whole situation?

2) this seemed to be pretty far out of the scope of a gynecologist's duties, especially when I had only come in for birth control. He was refusing to give it to me until he'd lectured, though, and it would've taken me another 2 weeks to get an appointment elsewhere, and by then I'd be late for the shot and at risk for pregnancy. And he knew it.

3) Do I have any recourse here other than finding a new doctor?

4) How do I make sure I avoid having this kind of problem in the future? I have good insurance and can take my pick of a bunch of doctors. Saying to a co-worker "who's your gyno?" strikes me as...a bit personal. How do I manage to find someone who won't do this same crap?