ENDOMETRIAL ABLATION FOR DYSFUNCTIONAL UTERINE BLEEDING - ROLE OF GNRH AGONISTS

OBJECTIVE: To discuss a new alternative to treat patients with dysfunc tional uterine bleeding who fail to respond to hormonal treatments, an d to outline the role of GnRH analogs in the presurgical preparation o f these patients. METHOD: The causes and various hormonal treatments o f dysfunctional uterine bleeding are outlined, and various methods of endometrial ablation, with hormonal and non-hormonal preparations, are reviewed, RESULT: In endometrial ablation, while hormonal preoperativ e treatments are more advantagous than no endometrial suppression, GnR H analogs prepare the endometrium better by reducing thickness uniform ly, decreasing edema, and avoiding pseudodecidual reaction usually pre sent with other hormonal treatments. CONCLUSION: Because success of en dometrial ablation seems to correlate with uniform destruction of endo metrium and superficial portion of myometrium, thinning of the endomet rium hormonally simplifies the procedure, adds in the overall success of endometrial ablation, and reduces additional blood loss by controll ing the bleeding preoperatively.