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Surgery for heavy periods

Key points about surgical options for heavy periods

If you have tried medication treatments for your heavy periods with no improvement, surgery may be your next option.
You may consider surgery if you: couldn't try medicine because of other health issues; tried medicine but it didn't help; or have fibroids or other conditions that cause bleeding and pain (eg, endometriosis).
Surgery aims to stop bleeding and pain completely by removing or reducing the cause.
There are 3 main operations used to treat heavy menstrual bleeding – endometrial ablation, myomectomy and hysterectomy.

Young woman doubled over on couch with abdominal pain

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This treatment involves using heat or freezing to destroy the lining of your uterus. The aim is to leave very little of the lining tissue. This usually reduces or stops menstrual periods. In some women, bleeding does not stop but is reduced to normal or lighter bleeding.

If this procedure does not control the bleeding, further treatment or surgery may be required. Endometrial ablation is only performed in women who no longer wish to have children.

Myomectomy removes fibroids from your uterus. Sometimes this involves one long cut across your belly (abdominal myomectomy) or several small cuts across your belly (laparoscopic or ‘keyhole’ myomectomy). Sometimes it is done using a hysteroscope and there are no cuts at all (hysteroscopic myomectomy). This is done under general anaesthetic.

Myomectomy is the best surgical option for women who want to be able to have (more) children.

Hysterectomy is an operation that involves removing your uterus (womb). There are more side effects and recovery takes longer, and this is recommended only if other methods to control the bleeding have been unsuccessful, however the decision to have a hysterectomy is made by you in consultation with your gynaecologist. Depending on the reason for the surgery, all or only part of the uterus may be removed. Hysterectomy is only performed in women who no longer wish to have children. Read more about hysterectomy.