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Origin of premenstrual syndrome: assessment by endometrial ablation
11700 Mistletoe Boulevard, Fort Worth, TX 67104, USA.
Study Objective:
To determine the origin of premenstrual syndrome (PMS) by endometrial ablation.
Design:
Evaluation of 108 consecutive women requiring endometrial ablation.
Setting:
The study was conducted in several hospitals and a surgical center in Fort Worth, Texas. Evaluation of patients was done in-office.
Patients:
The women had disabling uterine bleeding not related to malignancy. Of the 108 women, 6 were having a second procedure.
Interventions:
All women underwent endometrial ablation with the rollerbar resectoscope under local stand-by anesthesia, with suction curettage preparation of the uterus.
Measurements And Main Results:
The 73 women who were identified with PMS were evaluated by a 12-point protocol preoperatively and between 1 and 2 years postoperatively to gain insight into the origin of PMS. After surgery most of them were initially amenorrheic and essentially free of symptoms; however, with recurrence of bleeding PMS often recurred. Persistence of amenorrhea after ablation was associated with continued relief of PMS.
Conclusions:
We postulate that the etiology of PMS in women with disabling menstrual bleeding involves products from or substances in endometrial tissue.