Treatment of recurrent bleeding disorders during hormone replacement therapy by transcervical endometrial ablation

If bleeding disorders, which could not be treated by modification of steroi d dosages, occurred during sequential hormone replacement therapy (HRT), mo st of the patients stopped HRT. In these cases a diagnostic outpatient hyst eroscopy with biopsy was carried out. In most of the cases no intrauterine cause for the bleeding disorder was found. In 35 patients we performed an e ndometrial ablation without intra- or postoperative complications. After th is procedure all patients received a combined continuous HRT. In a follow-u p of 12 months 34 patients were amenorrheic and satisfied with the treatmen t. One patient stopped HRT because of suffering from other side effects. En dometrial ablation represents a method of treating patients with bleeding d isorders without intrauterine causes with a minimal invasive procedure. A c ontinuous combined HRT is possible after the endometrial ablation in perime nopausal and postmenopausal patients without bleeding disorders. In selecte d cases endometrial ablation can contribute to the increase of the complian ce with HRT.