Hot flashes and endometrial ablation

[ClearSkies]

I'm 44 and have been in perimenopause for 4 years.  I've taken birth control pills for regulating my period, lastly on Lo-Ovral, when after 2 years my periods have become irregular again.  My gyn has me taking FemHRT and has recommended endometrial ablation as the next step.
I exercise regularly, do yoga at least twice a week, and meditate daily.  I'm still sweating.  After a hot flash it takes about 1 1/2 hours to cool down.  My thyroid levels have been testing normal for the last 4 years, and the hot flashes have become worse.
Will an endometrial ablation relieve my hot flashes (it doesn't sound like it would) or just the heavy and irregular bleeding?  If so, what would be the effective treatment for the hot flashes which have made me depressed and embarassed for so long?

[Machelle Seibel, MD]

A. Endometrial ablation uses heat to destroy the uterine lining so it won’t bleed anymore. It won’t help hot flashes at all. Sometimes if the uterine lining keeps bleeding, it is helpful to look inside the uterus with a hysteroscope (a thin telescope) to be sure there isn’t a polyp or other cause of the bleeding.  If that is normal, then adjusting the hormones is often successful in regulating both the bleeding and the hot flashes. It is possible that you were making some estrogen at age 40 and now 4 years later, your estrogen production is lower so you need to take more estrogen/progestone to reduce hot flashes.
Machelle M. Seibel, MD