Treatment for Abnormal Uterine Bleeding (AUB) Shifting to Minimally Invasive Alternatives with Endometrial Ablation

By Dr. Kelli Miller, MD, FACOG, Women First, Louisville, KY

Dr.Kelli Miller

By Dr. Kelli Miller, MD, FACOG, Women First, Louisville, KY


One in every five women will suffer from heavy periods during their lifetime, and more than 80% of women with abnormal uterine bleeding (AUB) find their heavy period disruptive to their mental, emotional, and physical well-being.1,2 Patients suffering from AUB seek treatment because they are overwhelmed with symptoms of heavy bleeding, exhaustion, and in severe cases, anemia. As a minimally invasive OBGYN, I’m dedicated to offering women treatment options that are non-invasive, yet most impactful for their menstrual disorders. When hearing these patients’ concerns and health goals, I am passionate about counseling them on the available treatment options that may be right for them and providing them with the option that will best serve their lifestyle and fit their unique needs. I am consistently looking for the most innovative, trusted, and best performing gynecologic solutions for my patients.

Hysterectomy is no longer the end-all-be-all solution to menstrual disorders, and rather should be treated as a last resort only after all other options have been exhausted. Hysterectomy is the most invasive and extreme way to treat AUB, and also comes with a 6–8-week recovery period, which can be difficult to manage when it comes to time off work and other responsibilities, let alone many patients’ desires to preserve their uterus. I’ve made it my goal to increase awareness in the industry that minimally invasive solutions are not only the future of our practice, but the future of medicine as a whole, which will lead to a decreased burden on the healthcare system. That’s why endometrial ablation is a fantastic option for my patients dealing with AUB. Endometrial ablation is a non-hormonal, minimally invasive, one-time solution that does not require incisions. The procedure surgically destroys, or ablates, the endometrial lining of the uterus, resulting in reduced menstrual flow, or the elimination of one’s period entirely. This treatment option is key to providing patients with the symptomatic relief they seek as well as a quick and effective treatment option that won’t lead to additional life burdens or interruptions.

With 20 years of experience treating patients with menstrual disorders like AUB, I have had the chance to use a number of different endometrial ablation devices during my career. In my experience, the factors that are most important to me are ease of use, quickness and efficiency of the procedure, success rate, low patient risk and high standard of recovery.

I’ve been using the NovaSure® device as a minimally invasive OBGYN for as long as I can remember, probably for two decades and I recall learning how to perform endometrial ablations in training. In fact, I have personally received this treatment with the NovaSure device, and for that reason, when I counsel my patients, I understand from both a patient and physician perspective. The NovaSure device is a gamechanger for women suffering from periods ruling their life.

I recently had the pleasure of being the first physician to perform an endometrial ablation using the new NovaSure V5 device, and I was pleasantly surprised by how user-friendly the advancements were. It was clear the device had been updated with physician feedback in mind and I appreciated the new innovations, such as an updated cervical seal which is designed to increase the sealing surface and accommodate a range of cervical canals and anatomical variability.3,4,5 Every patient is unique, and ultimately, has a unique anatomy, so the tools with which we use to treat menstrual disorders should be able to cater to each woman’s individual needs. With this device I feel confident that I can provide my patients the option to receive this gold-standard of treatment, because it can now contour to a range of body diversity and cervical anatomy. 5 In addition, I found the improvements easy to adapt to when using the updated device so there should be no intimidation when it comes to using this new technology.

At Women First, we have the capability to perform ablations in a comfortable and convenient setting, in our in-office surgical suite. With the added benefits of the new NovaSure V5 device, I feel confident I am providing a gold standard, one-time procedure to treat the symptoms of AUB.

Disclosure: Dr. Miller is a paid consultant for Hologic, Inc. for the NovaSure endometrial ablation device. To learn more about the NovaSure procedure, including full Important Safety Information, visit


  1. Hologic, Inc. Data on File; AUB Patient Journey Research, conducted January 2017. Survey of 1,003 women who self-identified as currently or recently experiencing heavy bleeding with need to change feminine hygiene product every hour or more.
  2. Centers for Disease Control and Prevention. Heavy menstrual bleeding.
  3. NovaSure V5 cervical seal drawing, FAB-18821
  4. Baggish, M.S., Karram, M/M., Atlas of Pelvic Anatomy and Gynecologic Surgery. 4th edition. Elsevier 2016. ISBN: 978-0323225526. Chapter 44, Page 493.
  5. Luo, J. et al. Quantitative analyses of variability in normal vaginal shape and dimension on MR images. Int. Urogynecol (2016) 27:1087-1095

Important Safety Information

NovaSure® endometrial ablation is for premenopausal women with heavy periods due to benign causes who are finished childbearing. Pregnancy following the NovaSure procedure can be dangerous. The NovaSure procedure is not for those who have or suspect uterine cancer; have an active genital, urinary or pelvic infection; or an IUD. NovaSure endometrial ablation is not a sterilization procedure. Rare but serious risks include, but are not limited to, thermal injury, perforation and infection. Temporary side effects may include cramping, nausea, vomiting, discharge and spotting. Inform patients to contact you if they experience a possible side effect related to use of this product. For detailed benefit and risk information, please consult the IFU.


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