The latest medical procedure for women with abnormally heavy periods being touted as a major gynaecological advance carries a number of possible risks, including hysterectomy, increased period pain and the development of fibroids.

The first tests have been carried out at London's Royal Free Hospital for transcervical resection of the endometrium (TCRE), or removal of the lining of the womb, for women with abnormally heavy periods. This new procedure is meant to replace the more radical treatment of choice: hysterectomy.

Although the study noted that "operative complications were uncommon," four women had a uterine perforation (which did not develop into anything serious), seven absorbed more than 2 litres of fluid and one needed help in controlling post operative bleeding.

Although over 90 percent of the patients enjoyed improved menstrual symptoms, between 27- 42 of the women became amenorrhoeic (lost their periods) at some point in the two and a half years of follow up, 16 needed repeated TCREs,10 of the women underwent hysterectomy, 2 reported severe cyclical pains a year or less after surgery (and with others menstrual pain worsened). The majority were left with a severely shrunken uterine cavity that had developed fibroids.

The study also found that women over 35 tended to do less well than younger women. "The prevalence of de novo cyclical pain was much less than 25 per cent in our study but is nonetheless an important adverse effect of TCRE," wrote the authors.

Although the medical weekly Pulse proclaimed that 18,000 women a year could substitute out patient surgery for hysterectomy, it did underscore the need for long term follow up studies of at least 700 patients, and quoted study coordinator Dr Mark Broadbent: "We need to know whether in 10 years time all these women will be back to square one." Or possibly worse.