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.
- Radio frequency: 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 gynaecologist 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).
eGynaecologist Advice
- You should seek gynaecological consultation if you develop heavy bleeding, severe pain or raised temperature following 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.
Frequently Asked Questions
Can I get pregnant after ablation?
No – ablation damages the uterine lining, but it is not birth control. Use contraception to prevent dangerous ectopic pregnancies.
Will ablation affect my hormones?
No—ovaries remain intact, so menopause occurs naturally.
Does ablation cause menopause?
Only if ovaries are removed (oophorectomy), which is a separate procedure.
What if my bleeding returns?
Contact your gynaecologist—new bleeding could signal a new condition (e.g., fibroids).
