NovaSure: A Minimally Invasive Solution for Abnormal Uterine Bleeding
Abnormal uterine bleeding (AUB) is a common yet distressing condition affecting millions of women worldwide – up to one in three.1 General practitioners and family doctors play a pivotal role in the initial management and referral of these patients. While hysterectomy has traditionally been viewed as a definitive solution, it is essential to also consider less invasive options that can provide significant relief with fewer complications and faster recovery times.
One such option is NovaSure, an endometrial ablation procedure that offers a promising alternative for many patients. Endometrial ablation has been widely considered by the Society of Obstetricians and Gynecologists of Canada (SOGC) a safe and effective treatment alternative to hysterectomy to treat abnormal uterine bleeding.2
Understanding NovaSure
NovaSure is a minimally invasive, outpatient procedure performed by gynecologic surgeons designed to treat AUB by removing the endometrial lining of the uterus. This treatment is suitable for premenopausal women who have completed childbearing and are experiencing heavy menstrual bleeding not attributable to other underlying conditions such as cancer.3 NovaSure has been available in Canada for over 20 years and worldwide has treated over 3 million patients.4 Clinical studies of NovaSure show excellent outcomes: 96% of women in one study had a reduction in bleeding at 5 years; 90% of women in the same study avoided hysterectomy;5 and another study indicated a 92.8% satisfaction rate. By targeting the endometrial tissue responsible for menstrual bleeding, NovaSure can significantly reduce or even eliminate heavy bleeding.6
How NovaSure Works3
The procedure utilizes a specialized device that delivers radiofrequency energy to the endometrial lining. NovaSure delivers a customized ablation to every patient, based on the unique characteristics of their uterus.
Benefits of NovaSure6
For many women, NovaSure offers several compelling advantages over more invasive treatments like hysterectomy:
- Minimally Invasive: The procedure is performed through the cervix, eliminating the need for incisions and reducing the risk of complications associated with open surgery.
- Quick Recovery: Most patients can return to normal activities within a day or two, compared to several weeks of recovery following a hysterectomy.
- Effective: Clinical studies have shown that the majority of women experience significant reduction in menstrual bleeding, with some achieving complete amenorrhea.
- Preservation of the Uterus: NovaSure allows women to retain their uterus, which can be important for those who wish to avoid the emotional and physical impacts of hysterectomy.
- Cost-Effective: As an outpatient procedure, NovaSure can be more cost-effective than inpatient surgical options, making it an attractive choice for both patients and healthcare systems.
Patient Experiences
Luiza was treated for heavy periods with NovaSure over two years ago. In speaking about her experience she says “you don’t have to wait around until menopause to have this freedom”.
Maria’s family physician gave her the option of endometrial ablation and referred her to a gynecologist when she said she was looking for a minimally invasive treatment of her heavy, painful periods. “I was up and living my life within three or four days” after her procedures.
Candidate Selection3
While NovaSure is a highly effective treatment for many women, it is not suitable for everyone. Ideal candidates are those who:
- Have completed childbearing
- Suffer from heavy menstrual bleeding not attributable to other uterine pathologies such as fibroids larger than 3 cm or endometrial hyperplasia
- Do not have a current or recent uterine infection
- Are not experiencing menopause
The Referral Pathway
General practitioners and family doctors are essential in the referral pathway for patients suffering from AUB. Early identification and appropriate referral to a gynecologist are crucial steps in managing this condition effectively. During patient consultations, it is important to:
- Educate: Inform patients about the variety of available treatments, including minimally invasive options like NovaSure. Sharing resources like the NovaSure patient brochure can be very helpful for many patients in making informed decisions about treating their AUB.
- Assess: Evaluate the patient's medical history, symptoms, and preferences to determine the most suitable treatment approach.
- Refer: Provide timely referrals to gynecologists who can offer specialized care and perform procedures like NovaSure.
Emphasizing that hysterectomy is not the only option is critical. While hysterectomy may be necessary for some cases, many women can benefit from less invasive procedures like NovaSure, which offer effective outcomes with fewer risks and shorter recovery times.7
NovaSure represents a significant advancement in the treatment of abnormal uterine bleeding, offering a less invasive, effective, and convenient alternative to hysterectomy. Encouraging discussions about all available treatment options ensures that patients receive the most appropriate and personalized care for their condition.
Considering NovaSure in the referral pathway can help many women achieve relief from AUB while preserving their quality of life and minimizing the impact on their daily activities. It is an important option to discuss with patients, ensuring they are aware that hysterectomy is not their only solution.
To learn more, visit the product page for NovaSure.
Davis E, Sparzak PB. Abnormal Uterine Bleeding. 2025 Jan 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 30422508.
Leyland N, Laberge P, Evans D, Savard EG, Rittenberg D. Guideline No. 453: Endometrial Ablation in the Management of Abnormal Uterine Bleeding. J Obstet Gynaecol Can. 2024 Sep;46(9):102641. doi: 10.1016/j.jogc.2024.102641. Epub 2024 Aug 20. PMID: 39168283.
NovaSure Instructions for Use AW-09898-001 Rev 010, Marlborough, MA: Hologic Inc; 2020.
Hologic, Inc. Data on file; 2004-2018. Based on units shipped from 2004-2018.
Smith PP, Malick S, Clark JT. Bipolar Radiofrequency Compared With Thermal Balloon Ablation in the Office A Randomized Controlled Trial. Obstet Gynecol. 2014 Aug;124 (2 Pt 1):219-25
Cooper J, Gimpelson R, Laberge P, et al. A randomized, multicenter trial of safety and efficacy of the Novasure System in the treatment of menorrhagia. J Am Assoc Gynecol Laparosc. 2002; 9:418-428
Lethaby A, Sheppard S, Cooke I, Farquhar C. Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding. Cochrane Database System Review, 2000;