Questions to Ask Your Doctor

  • What is considered heavy or excessive menstrual bleeding?
  • What are my options for treating my heavy menstrual bleeding?
  • Do you offer Mara™ Water Vapor Ablation System for treatment of heavy menstrual bleeding?
  • What are my risks and benefits of undergoing treatment with the Mara Water Vapor Ablation System?
  • What will I experience before, during, and after treatment with the Mara Water Vapor Ablation System?

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Frequently Asked Questions

Please refer to the Patient Labeling for complete information on Mara, including risks and benefits and to understand if Mara is right for you.

Treatment Options for Heavy Periods

Depending on the reason for your excessive menstrual bleeding, your doctor may suggest that you first try medications. If medications do not work, or you are not allowed to take them for other medical reasons, your doctor may suggest other options such as the Mara Water Vapor Treatment. The following practices and procedures are currently available to treat excessive uterine bleeding due to benign causes. Your doctor will tell you what is causing your heavy periods, and which therapy may be beneficial for you.

Hormone Therapy

Hormone therapy, using combination estrogen-progestin or progestin-only medicines are conveniently available as oral contraceptive pills, patches, or injection, and are frequently used first, before trying surgical treatments. There are also several types of progestin-containing intrauterine devices that are inserted by a professional into the uterine cavity for contraception and control of bleeding. Hormone therapies require long-term use to maintain the effect and may have unpleasant side effects. There is no permanent effect on a woman’s fertility, however.

Dilatation and Curettage (D&C)

D&C was previously used more frequently to treat heavy menstrual bleeding while providing useful information through examination of the uterine lining removed. It requires sedation or general anesthesia to perform, because the cervix is dilated and the uterine contents are mechanically removed or suctioned away. There is no long-term effect on menses, and the procedure may need to be repeated. A D&C is now best used to obtain uterine lining samples for examination when necessary. If used frequently, a woman’s fertility may be impacted by the formation of scarring in the uterus.

Endometrial Ablation

Endometrial ablation uses heat, cold, or electrical energy to destroy the endometrium. The treatment is delivered by a variety of methods, but always through the vagina and cervix. The procedures may be performed under local or general anesthesia, and dilation of the cervix may be required. This treatment is indicated for women who do not wish to preserve fertility. Mara is an endometrial ablation option that gently delivers natural water vapor to the uterus to reduce heavy menstrual bleeding.


Hysterectomy is the most invasive therapy, with more risk; but it completely stops bleeding because the uterus is removed. It does require general anesthesia in a hospital setting and is associated with risks and complications of major surgery. Recovery is longer than the previously described methods, and there is no chance of having a pregnancy afterward because the uterus is removed.

Gynecology Web Resources

American College of Obstetricians and Gynecologists

American Association of Gynecologic Laparoscopists

Important Safety Information:

The Mara Water Vapor Ablation System is indicated to ablate the endometrial lining of the uterus in premenopausal women with menorrhagia due to benign causes for whom childbearing is complete. Pregnancy following the Mara procedure can be dangerous. The Mara procedure is not for those who have or suspect uterine cancer; have an active genital, urinary or pelvic infection; or an IUD. As with all surgical procedures, there are risks and considerations associated with the use of the Mara Water Vapor Ablation System. Please refer to the device labeling for a detailed discussion of the device’s intended use, relevant warnings, precautions, side effects, and contraindications.