An e-mail from a 39 year old Wisconsin woman stated she was frustrated because her heavy periods and severe cramps continued despite undergoing a D&C, a trial of progesterone hormone therapy, and multiple doses of ibuprofen. She said her physician told her she needed a vaginal hysterectomy to control her bleeding but because of her age and she smokes, she could not be placed on birth control pills. His matter of fact comment that a \\\\"vaginal hysterectomy would easily take care of her problem\\\\" troubled her. She was e-mailed her back asking how she obtained my name. She was asked why she didn't like her doctor's treatment options. Her answer was surprising and reminded one \\\\"what a small world we actually live in.\\\\" Apparently, this woman's grandmother gave her a copy of the January 2001 50+ Newspaper that contained an article titled \\\\"Keep Your Cervix.\\\\" Her grandmother was given a used copy of this newspaper by a woman in Branson, Missouri.

As simple as it may sound, her abnormal bleeding and severe menstrual cramps could be either controlled or completely stopped by having a 10 minute outpatient procedure. This procedure that ablates/destroys the lining of the uterus is called ThermachoiceTM. The ThermachoiceTM system uses a balloon that is placed in through the cervix and into the uterus. Warm water slowly flows into the balloon gently heating up the cells that line the inside surfaces of the uterus. The heat energy destroys the surface cells during the five minute portion of the treatment. ThermachoiceTM can be done either under heavy intravenous sedation or under general anesthesia. This conservative treatment is not available at all hospitals, more often it's performed at outpatient surgical centers.

When the lining, called the endometrium, of the uterus is destroyed by ThermachoiceTM approximately 70% of women will experience resolution of abnormal menstrual bleeding. The majority of women who tried this method will never have another menstrual period in their lives. In addition, most women will find that their severe menstrual cramps will either cease to exist or drop significantly in severity. This is because those endometrial cells that bleed during a menstrual period are the same cells that produce the chemical prostaglandin that cause menstrual cramps.

The older technique is still performed occasionally to destroy the lining of the uterus but it requires a lot more surgical skill since lasers or electrical cautery tools have to be safely manipulated through a small scope placed within the uterus. For this reason, fewer gynecological surgeons are trained in these treatment options. Insurance companies have welcomed ThermachoiceTM because there is less expense in the operating room, because surgery time is shortened, fewer staff are needed and anesthesia costs are reduced. Unlike having a hysterectomy, using ThermachoiceTM is done as an outpatient procedure which requires less recovery time and eliminates missing work.

However, a couple newer prescription drugs called Vioxx® and Celebrex® are now available . It is a good idea to try one of these more powerful anti inflammatory medications 3-5 days each month during one's menstrual flow before going to surgery for painful cramps and heavy menses.

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