An endometrial ablation is a procedure your doctor might consider if you bleed between your menstrual periods, have a heavy flow, or have periods that last a long time. If medicine doesn’t help, your doctor might suggest endometrial ablation. It can curb the bleeding or stop it totally.
Heavy menstrual bleeding can have many causes. Changing hormones might be the reason. Or it could be fibroids and polyps growing in your uterus.
Endometrial ablation removes the endometrium, which is the lining of the uterus. In most cases, your period will return to normal or light flow, although it sometimes will stop completely.
Who Gets It
Endometrial ablation can put an end to heavy bleeding that gets in the way of your everyday life (maybe you need to change your tampon or pad every hour, or you bleed for more than a week). If your bleeding causes other health problems, like anemia, this procedure could also help.
Still, endometrial ablation isn’t right for everyone. If you’re post-menopausal, you shouldn’t have it done. It’s also not recommended if you have:
- Uterine, cervical, or endometrial cancer
- Pelvic inflammatory disease (PID)
- A vaginal or cervical infection
- A weak wall to your uterus
- An infection of the uterus
- A scar from a Caesarean section
- An intrauterine device (IUD)
- A disorder of the uterus or endometrium
Endometrial ablation isn’t invasive (it doesn't require an incision). The doctor doesn’t make any surgical cuts. Instead, they will insert very thin tools through your vagina to reach your uterus. The types will depend on what kind of ablation they do.
The most common are:
Hydrothermal: Your doctor gently pumps fluid into your uterus, then heats it. After 10 minutes, this destroys your uterine lining.
Balloon therapy: Your doctor guides a thin tube with a special balloon on the end into your uterus. Heated fluid fills the balloon, which then expands and destroys the lining.
High-energy radio waves: Your doctor puts electrical mesh into your uterus and expands it. Then energy and heat sent by strong radio waves damage the lining, which your doctor removes with suction.
Freezing: A thin probe with a very cold tip freezes off the lining of your uterus. Your doctor may call this “cryoablation.”
Microwave: A special wand applies microwave energy to your uterine lining, which destroys it.
Electrical: Your doctor can use an electric current to destroy the lining of your uterus, but this method isn’t as commonly used as the others.
Sometimes doctors can do endometrial ablation in their office. Or you may need to go into the hospital.
As with any medical procedure, there’s a small chance of infection or bleeding. The tools your doctor uses for your ablation could also create a hole in your uterus, cause burns, or harm nearby organs. But these problems don’t happen very often. The chances that you’ll get hurt during an endometrial ablation are low.
It shouldn’t take you long to heal from an ablation. Most women are back to their normal routine within a few days.
You may have some cramping and bleeding for a few days and a watery or bloody discharge for up to 3 weeks. It’s also common to have nausea and an urge to pee for the first 24 hours.
Your doctor will advise you not to have sex, use tampons, or douche for a few days. They may also put limits on your activity. If you need medicine for pain, ask your doctor which over-the-counter medicines are safe to take. Don’t take aspirin. It could make you bleed more.
If you have any of these signs, call your doctor right away:
- Strong-smelling discharge from your vagina
- Intense cramping or stomach pain
- Heavy bleeding or bleeding that doesn’t stop 2 days after your ablation (though spotting is normal)
- Trouble peeing
The results of endometrial ablation don’t always last. After a few years, your periods may start to get heavier and longer again. If so, let your doctor know. You may need a different treatment.