Surgery is generally reserved for treating dysfunctional uterine bleeding that can't be controlled with medication.

Surgery Choices

The following procedures are used to treat dysfunctional uterine bleeding.

• Hysteroscopy can be used to diagnose and treat dysfunctional uterine bleeding at the same time. A lighted viewing instrument called a hysteroscope is inserted through the vagina and cervix and into the uterus. When areas of bleeding are located, biopsies can be taken and then the areas of bleeding can be treated with either a laser beam or electric current (electrocautery).
• Endometrial ablation is a minimally invasive alternative to hysterectomy when other medical treatments fail or when you or your doctor have reasons for not using other treatments. Endometrial ablation scars the uterine lining, so it is not a treatment option if you are planning to become pregnant.
• Hysterectomy is the removal of the uterus. It may be done when a sample of the uterine lining (endometrial biopsy) shows abnormal cell changes or cancer, when uterine bleeding is uncontrollable, or when the cause of chronic bleeding cannot be found and treated. A hysterectomy is a major surgery with risks of complications. Recovery from surgery can take 4 to 8 weeks, depending on the type of hysterectomy performed. If the ovaries are also removed, you may need to take long-term estrogen replacement therapy after surgery.

What To Think About

Hysteroscopy is typically done to rule out serious uterine conditions:

• Before long-term treatment with medications or surgical treatment for dysfunctional uterine bleeding.
• When uterine bleeding has continued despite nonsurgical treatment.