What You Need to Know About an Endometrial Ablation

What You Need to Know About an Endometrial Ablation

If you experience extremely heavy periods or bleeding that lasts longer than eight days, endometrial ablation can help or even eliminate your menstrual bleeding. Endometrial ablation may also be recommended if you have bleeding between periods or if your bleeding is so heavy that it causes you to be anemic. It is often recommended as a treatment for excessive blood loss during your period. Prior to recommending an endometrial ablation, your healthcare provider may suggest using certain birth control medications or an intrauterine device (IUD) to treat the problem, but if these options are not possible for you or don’t help, endometrial ablation may be an alternative.

excessive monthly bleeding

Causes of Excessive Menstrual Bleeding

Menstrual bleeding problems may be caused by:

  • Hormonal imbalance
  • Fibroids
  • Polyps
  • Cancer of the endometrium or uterus

It is important to note that endometrial ablation isn’t generally recommended for postmenopausal women or women who have cancer of the uterus (or have an increased risk of it.) Certain abnormalities of the uterus or an active pelvic infection are also conditions for which endometrial ablation isn’t generally a recommended therapy.

Access to the Uterus in Endometrial Ablation

Endometrial ablation does not involve incisions in the skin, so it is not categorized as a surgery. Many types of endometrial ablation can be performed in a healthcare provider’s office. Your healthcare provider will access your uterus through the vagina. The opening in your cervix will need to be dilated in order to allow for the passage of the instruments used in endometrial ablation. This can be accomplished with medication or the insertion of a series of rods that gradually increase in diameter.

Types of Endometrial Ablation

Your healthcare provider will remove or destroy the endometrium utilizing one of several methods:

  • Electricity: an electric current conducted through a wire loop or rollerball onto the uterus lining to destroy it. This requires general anesthesia.
  • Fluids (hydrothermal): uses heated saline fluid is pumped into the uterus for approximately ten minutes to destroy the lining. This method is often used for women who have an irregular-shaped uterus resulting from abnormal tissue growth like intracavity lesions or uterine fibroids.
  • Balloon therapy: utilizes a thin tube (catheter) with a balloon at the end inserted into the uterus. The balloon is filled with heated fluid, which destroys the uterine lining in two to ten minutes.
  • High-energy radio waves (radiofrequency ablation): electrical mesh is inserted into the uterus and expanded. The provider then sends an electrical current made by radio waves through the mesh to destroy the uterine lining in one to two minutes.
  • Cold (cryoablation): uses a probe to create ice balls to freeze the uterine lining. Ultrasound allows the doctor to monitor the creation of the ice balls. Each freeze cycle can require up to six minutes. The number of cycles required is related to the size and shape of your uterus.
  • Microwaves (microwave ablation): utilizes microwave energy set via a thin probe to destroy the lining in three to five minutes.

If needed, your provider can view the inside of your uterus using a tool called a hysteroscope during the procedure and use a camera on the hysteroscope to record it. A liquid or carbon dioxide gas to fill the uterus may be employed to enable a clearer view.

After Endometrial Ablation

After endometrial ablation, you might experience:

  • Menstrual-like cramps for a few days. Over-the-counter medications such as ibuprofen or acetaminophen can help relieve cramping discomfort.
  • A watery vaginal discharge with blood. This discharge is usually heaviest for the first few days after the procedure and may continue for a few weeks.

Happy young woman

For Dr. White’s outpatient procedures, you will need to arrange for someone else to drive you home. For the first 24 hours after the treatment, it is common to have to urinate more often than usual. You may want to wear a sanitary pad for the vaginal bleeding that typically occurs after the procedure.

It might take a few months to see the final results, but endometrial ablation usually reduces the amount of blood lost during menstruation. Most women will have lighter periods, and some will stop having periods entirely. As this procedure is not a sterilization procedure, it is very important to continue to use a reliable form of birth control. Although a pregnancy may still be possible, it is very likely to be problematic, such as an ectopic pregnancy, and end in a miscarriage because of the damage to the uterine lining. Some types of sterilization procedures can be performed at the same time as endometrial ablation.

Risks involved with Endometrial Ablation

Complications of endometrial ablation are rare. However, possible complications can include:

  • Overloading of fluid into the bloodstream
  • Bleeding
  • Infection
  • Heat or cold damage to nearby organs
  • A puncture injury of the uterine wall or bowel from surgical instruments

Be sure to inform Dr. White or your healthcare provider if you are allergic to or sensitive to medicines, iodine, or latex. You will also want to discuss any other risks you may have based on your individual healthcare conditions.


Endometrial ablation greatly reduces or eliminates menstrual bleeding. However, it is important to discuss the details of your health condition and future fertility plans with your healthcare provider prior to considering the procedure. If endometrial ablation is a good fit for you, it is often a very helpful treatment and has a small risk of complications.

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