Endometrial ablative techniques are increasingly being used to treat menorrhagia in women who have finished childbearing and want to avoid hysterectomy. Since the widespread introduction of these techniques, the indications have been widened to include perimenopausal women and women on hormone replacement therapy with unacceptably heavy bleeding. Apart from the importance of assessing the effectiveness of these techniques for these particular women, it must be remembered that the risk of endometrial cancer starts to significantly increase over the age of 45 and evaluation of the uterine cavity before surgery and in the event of any abnormal bleeding afterwards is required. For the same reason, a progestogen must be added to any oestrogen replacement given after such surgery.
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