Is Endometrial Ablation The Appropriate Treatment For Pelvic Pain?

I recently had a follow-up at the gynae clinic, with the consultant. She asked me ‘how was the bleeding?’

It’s about the same. It varies. My cycle varies from 21-30 days. I generally bleed for 7 days: spotting for the first day, 2-3 heavy days followed by days of spotting.

The doctors I have seen focus on two things. The amount of bleeding and the pain associated with the bleeding.

I was offered endometrial ablation and a hysteroscopy. These were offered because:

  • I’m anaemic
  • At the time of the initial appointment I was unable to take anti-inflammatories
  • Due to migraines and fibromyalgia it is not a good idea (in my opinion) to have the mirena coil fitted.

I was shocked when she told me ablation is where they burn the lining of the uterus. It stops as many prostaglandins being produced which is what causes the pain.

I was fuming when I arrived home. How on earth can they justify burning a functioning part of the body? That’s torture! Even if your body is under anaesthetic, which mine would be. I was also confused why they want to treat  set of symptoms with destroying healthy tissue.

https://www.nhs.uk/conditions/heavy-periods/treatment/

The Bigger Picture:

My pelvic pain symptoms aren’t just connected with heavy bleeding and pain. My pain includes:

  • Tethering pain:  On ultrasound it was discovered that my left ovary is tethered to my bowel. I am aware of this pain and it’s connection to movement and position. Since evidence of this I am aware of tethering pain in other locations (pouch of douglas and right ovary). Ablation isn’t going to stop tethered organs pulling and stretching.
  • Painful bowel movements: I experience this due to stretching of the bowel, which pulls on the tethered ovary. I don’t see how ablation will help pain from mechanical issues connected to bodily functions.
  • Painful urination: I suspect I have interstitial cystitis. A few days before my period my bladder can be extremely painful when it’s full and when it’s emptied. Again, how can endometrial ablation help with a painful bladder?
  • Location of my period pain: I experience period pain around my ovaries. I no longer experience excruciating uterine cramps( but I did for between two and three decades) – only excruciating ovary pain. Once again, how does endometrial ablation stop the pulling, twisting and gripping pain I feel with both ovaries during a period???

No More Periods! 

Whilst some may see this as a relief from the inconvenient, annoying monthly menstruation, I see it as an intrusion of my body’s natural cycle- both monthly and long-term. Even though I have many problems with this, it doesn’t mean I want the cycle to stop. My body is doing what it’s supposed to!

I do not understand how you can burn away the lining of the uterus to then have no periods (I think some people can still have them/ and that they can return). What about the hormonal cycle you still experience. You’re still meant to have periods- as dictated by your hormonal cycle.

To me, I see that as creating a gap from that which your hormones are managing to the inability to allow those changes to happen as you’ve had part of your body destroyed. It doesn’t make sense! Is a hormonal imbalance created as your body can’t do what the hormones are trying to make happen?

Your Right To Experience Menopause Is Taken Away From You

Menopause is something I want to experience. I think it’s a privelidge to have reached this part of my life. Not everyone is lucky enough to make it to the grand age of 45, which I have reached.

I Don’t Want More Surgeries To Treat The Effects Of Previous Ones

I feel if I start having surgery for pelvic pain it will eventually lead to additonal problems in the future, which will require more surgery. I read a study carried out in the US where 25% of women who had endometrial ablation needed hysterectomies in 5 years. That’s a big percentage. I want to avoid surgery as I feel it will create more thethering, which will lead to needing more surgery. It may end up being a viscious cycle.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3866051/

You May Have Five More Years Of This

To back up her suggestion of the ablation the consultant informed that I may have five more years of periods to deal with. That’s actually very positive. In only five years I may have reached menopause. That’s nothing compared to the thirty three years of pain and not quite as many years of heavy bleeding. I am so close to the end. I don’t want to cheat. I want to reach that goal myself, knowing I made the correct choices for the long term health and well being of my body, mind and spirit!

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