Finicky Fibroids and the Chances of Post Endometrial Ablation Syndrome

Miller Park Zoo, by W. Scifres
Fibroids mostly are actually not finicky, probably 2/3rds of women who have them, can keep them in quite silence. They won’t require any treatment at all in these 2 out of three women. Now having said that, I say most often no the fibroids won’t need treatment, definitely not needing any treatment initially, but that doesn’t mean they don’t need to be watched, poked, measured, and tested in other ways. Are you having pain, pressure, problems conceiving, and not flooding, but just a menstrual period that is on the side of annoying rather than forgettable? If the symptoms of your now properly measured and diagnosed fibroid get more than minor, there are alternatives. Cutting the fibroid off the lining can be done very non-invasively and even modestly bothersome symptoms are worth treating if that’s the case. And often when I do consultations many women haven’t even heard of their alternatives. We’ve reviewed some of the issues you and your gyno are going to struggle with. Infertility isn’t necessarily commonly due to fibroids: only 1% to be exact is due to fibroids, but a small fibroid can even make getting IVF hard. Exactly what should be done is based on: How big: grapefruit size lumps on the normal egg sized uterus, that’s large. The location of the fibroid: under the lining they bleed a bit more, poking at your bladder you pee a bit more, and deep in the pelvic area there can be pressure on upper legs, back or with bowel movements. How much bleeding? Well, good question there too: if you are anemic and cannot keep up then yes, it’s too much, and you must do something, even if it is an endometrial ablation. More kids planned? Absolutely you need to keep your uterus in working order. So what to be done? What about my gynecologic fibroid future crystal ball? Will you or won’t you need surgery ever, will you or won’t you need a hysterectomy if you first have a lesser procedure? Will you or won’t you go into menopause prematurely if you have a procedure like a uterine artery embolization? So how big will your fibroid grow? Will it ever shrink and will it ever produce the symptoms of pain and pressure if it doesn’t today? All great questions and not easily answered. And one of the questions that is raised: what about having a fibroid with endometrial ablation? We know it’s a bit more likely to fail if a woman has fibroids, particularly if they are large, and the whole of the uterine cavity is not successfully treated by one endometrial ablation treatment. But the exact incidence of post endometrial ablation syndrome after ablations are done in women with fibroids is not really known, but presumed to be just a bit higher. So discuss with your gyno about treatments that are right for you!


  1. I am 42 years old. I suffered with horrendous periods which lasted for three weeks extremely heavy bleeding and clots.

    I had the mirena coil fitted but my bleeding was still really heavy and the coil was expelled. My doctor tried fobbing me off but in the end sent me for a scan which is when fibroids were diagnosed. I had several small ones in the wall of uterus and one large one inside which was thought to be the cause of the heavy bleeding.

    I went to see a gynaecologist in 2006 and hysterectomy was discussed but I decided on novasure which I understood to be quite a new procedure in the UK. I had the procedure and everything was fine for first couple of years. Bleeding stopped all together but for the last few years I have suffered horrendous cramps at the time of my cycle.

    I have had a couple of scans since the procedure and the fibroids in uterine wall are increasing in size but not major. The pain every month lasts three or four days and is very low down and radiates more at left side. My GP gave me Mefemanic acid which caused bad side effects so I stopped taking.

    Planning to go back to see GP after reading lots about other women who have had similar problems post ablation. Not sure how long I can endure this pain.


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