NovaSure Endometrial Ablation Improves Heavy Bleeding and PMS

Written by on November 1, 2011 in Research & Technology - No comments

By Andrea Lukes M.D.

Heavy periods cause not only physical discomfort in terms of cramps, nausea and headaches; they also make women miss work and social events, and can lead to depression and anxiety. Ten million women suffer from heavy bleeding, but this number can be decreased through NovaSure Endometrial Ablation, a five-minute procedure in a doctor’s office that gently removes the lining of the uterus. The procedure is well-tolerated and safe. On average the discomfort during the procedure ranges from two to six, on a scale from zero up to ten. Most women rate the discomfort similar to menstrual cramps. Women who are not planning for any more children, who have a normal endometrial biopsy and who want relief from their heavy periods are good candidates for the NovaSure procedure.

How does it work?

The science behind NovaSure involves radiofrequency energy. Via the cervix, the energy is delivered through a slender wand that extends a triangular mesh device into the uterus that conforms to the contours of the uterine cavity. This energy is applied to the endometrium (or lining of the uterus) for an average of 90 seconds. The muscle of the uterus has less water content compared to the lining, so the muscle of the uterus serves as an impedance to stop the energy from spreading. After the procedure, the mesh device is pulled back into the wand, and both are removed from the uterus.

NovaSure improves the symptoms of PMS

Research coordinated by Carolina Women’s Research and Wellness Center (CWRWC) has shown that the Novasure Endometrial Ablation is not only highly effective for heavy menstrual bleeding, but that it improves symptoms of premenstrual syndrome (PMS). There is a large body of evidence supporting NovaSure endometrial ablation for the treatment of heavy or abnormal uterine bleeding.The one year amenorrhea rates (no bleeding) is between 44 to 56 percent; whereas, the five year amenorrhea rates climbs to 58 to 75 percent. Seven out of ten endometrial ablations are done using NovaSure.

Although how it benefits PMS is not known, recent research at CWRCW shows the symptoms of PMS did improve. We had a prospective cohort of 36 women from several practices who completed two validated daily questionnaires, the Daily Symptoms Report (DSR) and the Daily Record of Severity of Symptoms (DRSP).  This was done at baseline and then four to six months after the NovaSure Endometrial Ablation. We also had patients do a self-rating of PMS before and after having a NovaSure Endometrial Ablation. Ninety-seven percent of women reported improved PMS symptoms.

It is interesting to determine what associated symptoms women have who present with heavy periods. In a survey of 906 women with heavy periods, the most common associated symptoms included pain, mood changes and feeling tired, which are all part of PMS. The diagnosis of PMS includes prospective recording of symptoms that are restricted to the luteal phase of the menstrual cycle which impair some facet of a woman’s life (with the exclusion of other diagnoses). The symptoms of PMS can be divided into mood (affective) or physical (somatic). Remarkably, up to 85 percent of women have one or more symptoms of PMS.

Final Word

Although Novasure Endometrial Ablations are not indicated for PMS, it is important for health care providers and women undergoing the procedure to consider the impact on symptoms of PMS. As we counsel women on treatments for heavy periods, the fact that PMS symptoms may improve may help them make a more educated decision regarding their options.

The impact of the endometrial ablation treatment for heavy periods has not yet decreased the hysterectomy rate within the United States, but it has impacted the hysterectomy rate in England.Many experts expect that with the growing number of ablations, there will be a decline in hysterectomy rates within the United States.

Many women who have had a Novasure Endometrial Ablation procedure love having more energy and confidence and no longer dread that time of the month.

More information for providers and patients can be found at

Andrea S. Lukes, M.D., MHSc, FACOG
is the founder and lead investigator at the Carolina Women’s Research and Wellness Center (CWRWC) and is now in private practice at the Women’s Wellness Clinic in Durham, North Carolina. Dr. Lukes’ clinical interests include adolescent and adult abnormal uterine bleeding (including heavy menstrual bleeding), hemostatic disorders, contraception, uterine fibroids, endometriosis, female sexual dysfunction, vaginal atrophy, and menopause.  Her publications include the recent article on tranexamic acid in the 2010 October issue of Obstetrics & Gynecology.  She continues her clinical research with multiple on-going FDA clinical trials through the CWRWC.


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