In-office endometrial ablation and clinical correlation of reduced menstrual blood loss and effects on dysmenorrhea and premenstrual symptomatology.

Objective: To evaluate in-office Thermachoice III endometrial ablation on subsequent dysmenorrhea and premenstrual mood symptoms in relation to decreased menstrual blood loss.

Study Design: The study conducted was in a prospective cohort single group. Ablations were performed on 148 patients under parametrial block using dilute mepivacaine and oral anxiolysis for a diagnosis of menorrhagia. The primary endpoint was eumenorrhea or less, with secondary endpoints of dysmenorrhea reduction and premenstrual symptom alleviation. Patients were evaluated at 3 and 6 months postprocedure. Of 148 patients, 134 (90.5%) complied with follow-up.

Results: At 3 months, 52% were amenorrheic; 48% reporting hypomenorrhea. Results persisted at 6 months, with 50% and 48%, respectfully. Of 134 patients, 3 were considered nonresponders at 6 months. Mean hemoglobin values increased for all groups at each time endpoint. Of 115 patients, 79 reported baseline dysmenorrhea, with improvement in visual analog scale findings at both 3 and 6 months (p<0.005). Premenstrual mood symptoms of agitation, irritability and depression also improved at both 3 and 6 months.

Conclusion: In-office Thermachoice III endometrial ablation results in decreased dysmenorrhea and improved mood in relation to decreased menstrual blood loss.