Endometrial ablation is a minimally invasive procedure that removes or destroys the lining of the uterus (endometrium) to reduce or stop heavy menstrual bleeding (menorrhagia). It is not a sterilization procedure and does not remove the uterus.
Your gynaecologist may suggest this procedure if:
- You experience heavy, prolonged periods affecting your quality of life.
- Other treatments (e.g., medications, IUDs) have not worked.
- You do not plan future pregnancies (pregnancy after ablation is risky and not recommended).
This procedure is not suitable if:
- You have uterine cancer or precancerous conditions.
- You have an active pelvic infection.
- You wish to preserve fertility.
Benefits
- Reduces menstrual bleeding (most women have lighter periods or none).
- Quick recovery (1–2 days off work).
- No incisions (performed through the cervix).
Risks and Complications
- Common: Cramping, nausea, vaginal discharge (watery or bloody for 2–4 weeks).
- Rare:
- Uterine perforation.
- Infection.
- Fluid overload (if fluid-based methods are used).
- Failure to control bleeding (may require repeat procedure or hysterectomy).
Preparing for the Procedure
- Pre-procedure tests: Pregnancy test, ultrasound, or biopsy to rule out cancer.
- Timing: Done when you are not menstruating.
- Medications:
- Stop blood thinners (aspirin, ibuprofen) as advised.
- Take painkillers or antibiotics if prescribed.
What to Expect During the Procedure
- Duration: 10–30 minutes.
- Anaesthesia: Local anaesthesia, sedation, or general anaesthesia (varies by method).
- Methods:
- Thermal balloon: Heated fluid destroys the lining.
- Radiofrequency: Electrical energy removes tissue.
- Microwave: Uses microwave energy.
Recovery
- Immediately after: Rest for a few hours; mild cramping is normal.
- At home:
- Avoid tampons, sex, and strenuous activity for 2–3 weeks.
- Use pads for vaginal discharge (may last weeks).
- Follow-up: See your doctor in 2–4 weeks to check healing.
Effectiveness
- 80–90% of women see reduced bleeding.
- 30–50% stop having periods entirely.
- 10–20% may need repeat procedures or hysterectomy.
Alternatives
- Medications: Hormonal IUDs, birth control pills, tranexamic acid.
- Surgery: Hysterectomy (removes the uterus).
- Uterine artery embolization: Blocks blood flow to fibroids (if present).
Frequently Asked Questions
Q: Can I get pregnant after ablation?
A: No—ablation damages the uterine lining, but it is not birth control. Use contraception to prevent dangerous ectopic pregnancies.
Q: Will ablation affect my hormones?
A: No—ovaries remain intact, so menopause occurs naturally.
Q: Does ablation cause menopause?
A: Only if ovaries are removed (oophorectomy), which is a separate procedure.
Q: What if my bleeding returns?
A: Contact your doctor—new bleeding could signal a new condition (e.g., fibroids).
eGynaecologist Advice:
- You should seek gynaecological consultation if you develop heavy bleeding severe pain or raised temperaturefollowing the procedure of endometrial ablation.
- You may continue to have some bleeding or discharge for up to 4 weeks, which will not need any treatment. If these symptoms continue then contact your gynaecologist for consultation.
- You should seek gynaecological consultation for early assessment if you miss a period and have positive pregnancy test.
