Endometrial ablation is a procedure that destroys (ablates) the inner lining of the uterus. The primary indication for its use is to reduce and in some cases eliminate menstrual and uterine bleeding. After an appropriate evaluation with pelvic imaging and uterine sampling your provider can advise you if endometrial ablation is the best treatment option for you.
Abnormal uterine bleeding is one of the most common reasons for a woman to visit their gynecologist outside of their annual evaluation. Some of the most common causes for abnormal uterine bleeding are hormonal imbalances, uterine fibroids, or polyps. To determine the cause, typically an initial evaluation will include a blood draw to check hormone levels, an ultrasound to evaluate the patient’s uterus and ovaries, and an endometrial sampling to ensure that the endometrial lining is free of any abnormal cells.
What are the different types of procedures?
Endometrial ablation requires no incisions or surgery. Instead, this gynecologic procedure is performed through the vagina using small tools to reach the uterus.
This can be done using several different methods, taking as little as five minutes.
Methods include:
- Electricity: using a rollerball or wire loop, an electrical current is used to destroy the uterine lining
- Microwave: microwave energy may also be used to rid the uterus of its lining
- High-frequency radio waves: using an expandable electrical mesh placed in the uterus, your doctor sends electrical energy created through radio waves to destroy the inner lining of the uterus
- Heated fluids: heated fluid is placed into the uterus to destroy the uterine lining
- Cold probe: a cryogenic (very cold) probe is used to freeze the lining of the uterus
- Balloon therapy: a balloon at the end of a catheter is inserted in the uterus which is then filled with heated fluid. The heat from the fluid ablates the uterine lining
What are my risks and side effects?
While rare, endometrial ablation side effects may include:
- Bleeding
- Pain
- Infection
- Damage to nearby organs due to heat or cold
- Puncture of the uterine wall
How can I be prepared for the procedure?
In preparation for your surgery it is important to obtain endometrial sampling prior to ablating/destroying the endometrial lining. Your provider will also want to provide you with a pregnancy test to ensure you are not pregnant prior to this procedure. Other steps to prepare include advising your provider of any allergies to medications, other medical problems, or any other questions or concerns that you have. It is important to advise your provider of any future desire for pregnancy. If you would like to maintain your ability to become pregnant, endometrial ablation is not a good treatment option for abnormal uterine bleeding.
What should I expect during an endometrial ablation?
The procedure will either be performed in your doctor’s office, in a surgical center (as an outpatient procedure), or at the hospital. The location will depend on your condition as well as your health and your provider’s practice.
You will either be given local anesthesia or general anesthesia to promote your comfort during your procedure. The cervix will be dilated and, depending on the type of ablation, the appropriate device will be placed to complete your procedure.
What is my recovery time after endometrial ablation?
With endometrial ablation, recovery time is typically minimal, and most women who have undergone the procedure are up and around within a day or two. Cramping and vaginal discharge may be present while you heal for about 2 weeks. Cramping can be relieved with over the counter Ibuprofen for the first few days after the procedure.
After the procedure, will I see weight loss?
Endometrial ablation does not affect a patient’s weight.
What should I know after my endometrial ablation?
While results may vary, women typically experience much lighter menstrual flows – your periods may end altogether.
Even though becoming pregnant is less likely after the procedure, it is important to use some form of birth control if you are sexually active. Becoming pregnant after the procedure can be high-risk for you and your baby and could result in miscarriage or an ectopic pregnancy (pregnancy outside the uterus).
The results of the procedure typically last a few years. Depending on your age, the procedure can last until menopause and you may not bleed again. However, if bleeding increases, more definitive treatments such as hysterectomy may be evaluated with your provider.
Speak to us about endometrial ablation
If you are experiencing excessive menstrual bleeding, make an appointment with an Intermountain Health gynecologic specialist for a thorough evaluation to determine the best treatment option for you. Endometrial ablation is a simple, minimally invasive procedure that can successfully reduce or end bleeding and requires minimal recovery time, allowing you to get back to living your life.