Surgery for heavy periods

If you have heavy periods and have tried medical treatments with no improvement, surgery may be your next option.

There are 3 main operations used to treat heavy menstrual bleeding – endometrial ablation, myomectomy and hysterectomy.

Surgery may be considered if you: 

• couldn't try medicine treatments because of other health issues
• tried medicine but it didn't help
• have conditions, such as fibroids or adenomyosis, that cause bleeding and pain – read more about fibroids and adenomyosis as causes of heavy bleeding.

Read more about the the different types of surgery below. 

Endometrial ablation involves burning off the lining of your uterus (womb), usually by using heat or an electric current. It can be done under local or light general anaesthesia, usually as a day stay procedure. The aim is to leave very little of the lining of the womb behind. This usually reduces or stops menstrual periods. You may find the bleeding doesn’t stop completely but is reduced to normal or lighter bleeding. 

If this procedure doesn’t control your heavy bleeding, further treatment or surgery may be needed. Endometrial ablation is only performed if you no longer want to have children. It’s still possible to get pregnant after endometrial ablation, but it’s not safe to do so. This means you must use effective contraception afterwards – you might consider permanent contraception or sterilisation.

Myomectomy is a procedure that removes fibroids from your uterus. Uterine fibroids are benign (non-cancerous) growths usually found in the muscle of your uterus.

Image credit: Bruce Blaus via Wikimedia Commons(external link)

A myomectomy can involve 1 long cut across your belly (abdominal myomectomy) or several small cuts across your belly (laparoscopic or ‘keyhole’ myomectomy). Sometimes it’s done using a hysteroscope, which is a small telescope that’s inserted through your vagina and cervix into your uterus, and there are no cuts at all (hysteroscopic myomectomy). This is done under general anaesthetic. 

Myomectomy is the best surgical option if you have fibroids and you still want to be able to have a child. 

Hysterectomy is an operation to remove your uterus (womb), which means you’ll no longer be able to have a child. Hysterectomy is a complete solution for heavy bleeding, but does have some risks. The decision to have a hysterectomy is made by you and your gynaecologist together, and the risks and benefits will be explained. 

Depending on the reason for the surgery, all or only part of your uterus may be removed. Read more about hysterectomy.

Image credit: Bruce Blaus via Wikimedia Commons(external link)

All surgical options have different risks and benefits. Each procedure has different reasons for why it might or might not suit you, depending on the cause of your heavy bleeding. Talk to your healthcare provider about which option might work the best for you.