Dr. Robin Lynn Poe-Zeigler, MD

There are many different ways that the uterine lining can be removed, including radiofrequency, heat, microwaves, and cold. Ablations are usually performed with local anesthetic by an OB/GYN. A probe is inserted into the uterus through the vagina, and the end of the probe is expanded or moved around to access the uterine lining. Cramping and discharge afterwards are normal, but the procedure is not particularly painful.

Endometrial ablation is not for everyone. It shouldn't be done by women who have reached menopause, or women with uterine cancer or uterine infections. It is important to remember that an endometrial ablation does not remove the uterus or ovaries, so regular pelvic exams are still important after this procedure. Women who are considering endometrial ablation should also be done having children. Pregnancy is possible after an endometrial ablation, though not likely. If pregnancy does occur, an ablation increases the risks of miscarriage and other problems, so reliable birth control must be used after endometrial ablation all the way through menopause.

It is important to note that having any of these conditions does not necessarily mean that a hysterectomy is necessary. There are other available treatment options in most cases.

Although the uterus is responsible for a period, it is the ovaries that control the hormonal changes that women go through every month. So if a woman has a hysterectomy but keeps her ovaries, she might still experience hormonal swings every month even if she no longer has a period. Alternately, if a younger woman has a hysterectomy where her ovaries as removed, she will essentially be in immediate menopause.

A hysterectomy can be performed traditionally through one large cut in the abdomen, laparoscopically using tiny incisions and small tools, or through the vagina. Full recovery may take four to six weeks. After a hysterectomy, patients might experience sexual changes such as vaginal dryness or a change in libido. It is common to experience strong emotions after a hysterectomy, including both grief and relief. If a patient's ovaries were removed, they may be at higher risk for certain diseases, such as heart disease and osteoporosis. Taking hormonal birth control might reduce this risk.

Hashimoto's is the leading cause of hypothyroidism, which is when the thyroid does not produce enough hormones to stimulate adequate metabolism. The condition is diagnosed by blood tests that measure TSH (thyroid stimulating hormone) and detect Hashimoto's antibodies. Symptoms of hypothyroidism include sluggish metabolism, inflammation, fatigue, weight gain, brittle hair, dry skin, and sensitivity to cold. To supplement impaired thyroid function, patients with Hashimoto's are typically prescribed synthetic thyroid hormone pills. Such patients may need to consume synthetic thyroids for the rest of their lives. Other treatments may include dietary changes, such as the avoidance of certain foods and medication to reduce inflammation. Frequent blood tests can inform patients if their TSH levels are within a normal range.

Grave's disease is most frequently the cause of hyperthyroidism, which is when the thyroid produces too many hormones, overstimulating one's metabolism. The condition is also diagnosed by blood tests that measure TSH and detect Grave's antibodies. Elevated heart rate, high blood pressure, sweating, bulging eyes, and weight loss are common symptoms of hyperthyroidism. Treatments for hyperthyroidism include oral radioactive iodine, which slowly shrinks the thyroid, slowing the production of excess thyroid hormone. Other anti-thyroid medications such as methimazole (Tapazole) also reduce the production of thyroid hormones. Blood pressure medications known as beta blockers can ease the increased heart rate caused by hyperthyroidism. If treatments are unsuccessful, patients may be prescribed a thyroidectomy, or surgery to remove part or all of the thyroid. Some patients with hyperthyroidism may require ophthalmological (eye medicine) treatments such as eye drops, prednisone, and surgery to reduce eye swelling and bulging.

Untreated thyroid disorders frequently lead to goiters or thyroid nodules. A thyroid goiter is a large lump that can be felt near the base of the neck and is made of swollen thyroid tissue or nodules (excess cell growth). Nodules and goiters are diagnosed by CT scan or ultrasound. Obstructive goiters can cause pain, coughing, and abnormal breathing. The most common cause of goiters is hyperthyroidism (overactive thyroid). However, Hashimoto's is also known to cause goiters or nodules. Goiters develop from continued damage from antibodies to the thyroid over time. At times, a goiter can result from a cancerous thyroid tumor. Most goiters and nodules are themselves benign.

The exact causes of thyroid cancer are unknown. People who develop thyroid cancer may or may not have another thyroid problem such as Hashimoto's or Grave's disease. Symptoms of thyroid cancer include a nodule that can be felt on the neck, hoarseness, difficulty swallowing, swelling in the neck, and neck and throat pain. CT and MRI scans are used to diagnose thyroid cancer. There are four types of thyroid cancer which vary in intensity. Thyroidectomy (thyroid removal surgery) is usually prescribed to treat thyroid cancer.

Thyroid problems are often long-term conditions that require some form of treatment. With regular monitoring and medication, many people with thyroid problems are able to lead active and fulfilling lives.