Novasure treatment for vaginal bleeding is a significant improvement.

Novasure is a quick, safe and simple procedure to lighten or stop your periods, without the side effects of hormones or the risks of hysterectomy. We have been performing this procedure in our office for over 2 years and I have been impressed with how well it works. Just this past week I happened to see 3 patients who had this procedure done here in the past year or two. Each of them came in last week for a routine visit. They all reported that they did not have any bleeding since having the Novasure treatment. It reminded me of that old tv commercial involving the Maytag repairman. In the commercial he kept saying that he had little to do since Maytag washing machines hardly ever needed repair. Similarly I felt that after these patients were cured they did not need to come in to the office  because of having problems, but just for routine yearly visits. Before they were treated, they were having problems frequently. For these people the improvement in their quality of life was a huge change.

Many of our patients have heavy or irregular periods. Sometimes this may occur due to your age or due to being under stress or having an ovarian cyst. It may be a temporary condition that does not need to be treated. In many cases, however, the bleeding seems to persist and the consequences are heavy flow month after month resulting in a lower blood count with reduced energy and other symptoms. We have many such patients report these problems when they come in to see us.

1. Evaluation

Our first job is to make sure that the bleeding does not represent any potentially serious problem, such as cancer or pre-cancer. We evaluate the size of the uterus based on the physical exam, perform a pap test and look for other causes of bleeding such as pregnancy, tumors or cysts. Usually some testing is needed to make sure that a serious problem is not present. We often will evaluate the shape and size of the uterus and ovaries by ultrasound. This easy, modern test can be performed in our office without pain and is very useful in providing us with information that we need to evaluate the possible causes of bleeding. Sometimes it is also necessary to examine the uterus further such as by evaluating it’s interior visually (hysteroscopy) and getting a sample of endometrial tissue (D and C) to look for cancer or pre-cancer. This involves a short procedure which is usually done as an out-patient and for which anesthesia is given. Within a week or so the results are available and at that point we will have a meeting to bring together all of our information to come up with a plan of management.

2. Treatment choices

In many cases no treatment is needed, as the problem may be temporary and it may improve spontaneously. Sometimes, however, the problem is more serious and more thorough treatment should be performed such as by hysterectomy. This is particularly helpful when abnormal tissue that can lead to malignancy is found. In such a case we will discuss all of the treatment options before reaching a conclusion about what would be the best approach. On the other hand, in many cases the evaluation shows that treatment is needed, but a hysterectomy is more than is required. In these cases a minor procedure with major improvement such as Novasure may be the perfect choice.

Novasure is an office procedure that will bring a significant improvement in bleeding by either reducing it significantly or making it stop completely. It involves treating the inside of the uterus and destroying the tissue that causes bleeding. This is accomplished by inserting a slender wand that opens to have the appearance of a small copper fan. It conforms to the shape of the inside of the uterus. Precisely measured energy is delivered to the tissue and then the device is removed. This is known as endometrial ablation. The result is that the tissue no longer functions and the bleeding does not occur. The results can be dramatic.

The Novasure procedure is performed in our office. The entire procedure typically takes less than 5 minutes. It is performed without making any incisions. It can be performed under local anesthesia, I.V. sedation or general anesthesia. Most women report little or no pain, and return to their regular activities within a day.

Immediately after the procedure some women may have cramping. There may be a watery discharge as the tissue is healing. This is usually temporary and lasts for 7-10 days. In some cases there may be no discharge, and in some it may last longer. This is normal and it will go away when the healing is complete.

Novasure is highly effective for the treatment of abnormal vaginal bleeding, but it is not a birth control method. Because it treats the lining of the uterus, your chances of becoming pregnant after it are reduced. But it is still possible to become pregnant, and a pregnancy after an ablation could be dangerous for the mother and the fetus. It’s important to talk to us about different methods of birth control that are available if you are thinking about having a Novasure procedure done.

In my practice I have been impressed with how well this minor procedure works and brings about a major improvement. It usually will result in such an improvement in symptoms that hysterectomy will not be needed. This means that you will not need to miss much time from your work or from your family as your recovery will be rapid. I have found that our patients are very satisfied with the improvement from having a Novasure procedure. The studies that are quoted show that 95% of patients are satisfied with the results and 97% would recommend it to a friend.

This is another example of how medicine keeps changing, and the procedures that we used for many years and now being replaced by those which are much better in many ways. They are safer, easier for us to do, easier for the patient to have done, they have a faster recovery, give you more time for your family and for your work, and have fewer risks and complications. They cost less as they do not need to be done at the hospital.  They are less painful. While not for everyone,  if you have a problem with heavy vaginal bleeding Novasure is a safe and effective treatment that you should consider. It could be the best plan for you and significantly improve your life.

About Mark Seigel, MD

I'm an ObGyn with offices in Rockville and Germantown, Maryland. Our modern practice includes electronic medical records, advanced ultrasound, and in-office procedures. We offer gynecologic services, as well as normal and high risk obstetrics. I have three great partners, Drs Emily Gottlieb, Jennifer Jagoe and Supriya Mishra. We are part of George Washington University Medical Faculty Associates. I enjoy reading, swimming, and blogging.
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