| Q&A of the Week: Endometrial Ablation for Hyperplasia? | |
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Melanie writes: HELP! I've been diagnosed with hyperplasia without atypia (I think it was simple, too). I am being pressured into choosing a hysterectomy. I am post stroke, so I am refusing the hormone thrapies as too risky, but I am not prepared to lose my uterus and cervix at this point(I'm only 33). I've heard of the procedure called an ablation. Is this a viable option? I am getting a second opinion Tuesday, but since I have always had irregular periods, so I don't doubt the diagnosis. Aren't there any other options?
Hi, Melanie -
First of all, "Brava to you!" for seeking out the best treatment for you, and for trying to avoid surgery.
From what I can tell by my own reading and searching through the literature, endometrial ablation, although not a common treatment for endometrial hyperplasia, is a reasonable treatment, as long as there is no atypia (precancerous cells) present. Certainly I have found quite a few references to its successful use for women with hyperplasia without atypia, and I can't find a good reason not to try it.
It could be that some physicians shy away from the procedure because either they aren't familiar with it, or because there are nervous about atypical cells "lurking" somewhere. As far as I can tell, this latter is unfounded, as there is such a large gulf statistically between the danger of cancer when atypia isn't present (1-5%, similar to women with no hyperplasia) compared to when it is (25%). It also could be that since progestin therapy generally works well, some physicians haven't gotten around to thinking about alternatives. I think you are wise in your situation to start thinking creatively. Please tell us how it goes - I am truly interested in the outcome.
Laura
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