What is an endometrial ablation?

An endometrial ablation is a surgical procedure used to ablate the lining of your uterus. The goal of an endometrial ablation is to reduce or stop menstrual flow. During the procedure, your doctor will insert a medical instrument into the vagina and through the cervix. There are different methods used to destroy the endometrium including using extreme cold, heated fluids, microwave energy or high-energy radio frequencies.

Who is a candidate for an endometrial ablation?

If your menstrual bleeding is interrupting your day-to-day life (for example, you have to change your tampon or pad every hour or more or you are bleeding for longer than a week each month), you may be a candidate for an endometrial ablation.

An endometrial ablation is not appropriate for women in post-menopause or women who have any of the following conditions:

  • Uterine, cervical or endometrial cancer
  • Pelvic inflammatory disease
  • Cervical vaginal or uterus infection
  • Uterus infection
  • Disorders in the uterus or endometrium
  • Your uterus has a weak wall
  • You have an intrauterine device (IUD)
  • You have a scar from a previous C-section

What are the risks of an endometrial ablation?

Although an endometrial ablation is generally a safe procedure, complications can occur. Complications of an endometrial ablation include:

  • Infection
  • Bleeding
  • Burns in the uterus
  • Damage to other reproductive organs
  • Hole in the uterus

What to expect during an endometrial ablation?

Depending upon the type of endometrial ablation you are having, the procedure may be performed in a clinic office or a Mercy Health operating room.

In preparation for the procedure, your doctor will dilate your cervix with medication or a series of rods that increase the diameter. What you can expect will differ based on which type of procedure you are having.

Types of endometrial ablation include:

  • Hydrothermal
    During a hydrothermal endometrial ablation, your doctor will pump saline fluid into the uterus and heat it for 10 minutes to ablate the uterine lining. This procedure can be used for women who have growths such as fibroids that are causing the uterus to develop an irregular shape.
  • Balloon therapy
    During balloon therapy, a balloon is inserted into the uterus, filled with hot fluid and expanded. This process will ablate the uterine lining. This procedure takes approximately 10 minutes.
  • Radiofrequency (High-energy radio waves)
    This procedure uses strong radio waves, passed through an electrical mesh in the uterus. The radio waves will heat up as they pass through the mess, ablating the uterine lining within one to two minutes.
  • Cryoablation
    Cryosurgery or cryoablation uses a probe that is cooled to freezing temperature. The extreme cold will freeze the lining of the uterus. Your doctor will be able to track the progress of the procedure on ultrasound. You may need multiple cycles of freezing and thawing to achieve maximum results. Each cycle lasts approximately six minutes.
  • Microwave
    During a microwave endometrial ablation, microwaves pass through the uterus to heat and ablate the uterine lining. This treatment takes approximately three to five minutes.
  • Electrical (Electrosurgery)
    Rarely, your doctor may try an electrical endometrial ablation where an electrical current ablates the uterine lining. Electrosurgery is performed under general anesthesia.

Recovery from an endometrial ablation

Most women are able to return to their day-to-day routine within a week of the procedure. You may experience side effects such as:

  • Nausea
  • Urge to urinate
  • Cramping
  • Bleeding
  • Watery or bloody discharge

Your doctor will give you instructions on how quickly you can return to your normal activity schedule. Instructions include:

  • Do not have sex, use tampons or douche for approximately a week after the procedure.
  • Do not lift anything heavy until your doctor gives you clearance.
  • If you are in pain, over-the-counter NSAIDs are safe to take. Do not take any products that contain aspirin.

Call your doctor if you experience any of the following symptoms:

  • Foul smelling vaginal discharge that may indicate an infection
  • Fever
  • Chills
  • Stomach pain or cramping
  • Heavy, prolonged bleeding
  • Inability to urinate

Some women will need an alternative treatment a few years after an endometrial ablation if their periods become heavier and longer.

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