Endometrial Ablation

Surgery Overview

Endometrial ablation is a type of procedure that's often used to treat heavy menstrual bleeding. It can also be used for other types of bleeding in the uterus. It's not recommended if you plan to get pregnant.

Ablation works by destroying the lining of your uterus. As it heals, the lining will scar. This scarring reduces or prevents bleeding.

Your doctor may give you medicine to help you relax. You may also get medicine to help with pain. First, your doctor inserts a special tool into your vagina. This is called a speculum. It gently spreads apart the sides of your vagina. Next, the doctor may put a lighted tube through your cervix. This is called a hysteroscope or scope. It helps the doctor see inside your uterus. Then the doctor inserts a device to destroy the lining. This device may work in one of many ways. It may use a laser beam, heat, electricity, freezing, or microwaves.

Ablation can be done in a doctor's office. Or it may be done in a hospital. It usually takes less than an hour. You can go home after the procedure.

What To Expect

After the procedure, you may have some side effects, such as cramping, nausea, and vaginal discharge that may be watery and mixed with blood. This discharge will become clear after a couple of days. It can last for around 1 to 2 weeks.

It takes a few days to 2 weeks to recover. You will probably go home the same day.

Why It Is Done

Endometrial ablation is used to control heavy, prolonged vaginal bleeding when:

• Bleeding has not responded to other treatments.
• Childbearing is completed.
• You prefer not to have a hysterectomy to control bleeding.
• Other medical problems prevent a hysterectomy.

How Well It Works

Most women will have reduced menstrual flow after an endometrial ablation. And up to half will stop having periods.^{footnote 1}

The procedure is less likely to work in younger women than in older women. After an endometrial ablation, younger women are more likely to still have periods and need a repeat procedure.

Young women may be treated with gonadotropin-releasing hormone analogues (GnRH-As) 1 to 3 months before the procedure. This will decrease their production of estrogen and help thin the lining of the uterus (endometrium).

Risks

Problems that can happen during endometrial ablation include:

• Accidental puncture (perforation) of the uterus.
• Burns (thermal injury) to the uterus or the surface of the bowel.
• Buildup of fluid in the lungs (pulmonary edema).
• Sudden blockage of arterial blood flow within the lung (pulmonary embolism).
• Tearing of the opening of the uterus (cervical laceration).

These problems are uncommon but can be severe.