What is endometrial ablation?

Endometrial ablation is a type of procedure that's often used to treat heavy menstrual bleeding. It can also be used for other types of bleeding in the uterus. It's not recommended if you plan to get pregnant.

Ablation works by destroying the lining of the uterus (endometrium). As it heals, the lining will scar. This scarring reduces or prevents bleeding.

You may be given gonadotropin-releasing hormone agonists (GnRH-As) 1 to 2 months before endometrial ablation. This can help thin the lining of the uterus before the procedure.

For the procedure, your doctor may give you medicine to help you relax. You may also get medicine to help with pain. First, your doctor places a tool called a speculum into your vagina. This opens the vagina a little bit. Next, the doctor may put a lighted tube through your cervix. This is called a hysteroscope or scope. It helps the doctor see inside your uterus. Then the doctor inserts a device to destroy the lining. This device may work in one of many ways. It may use a laser beam, heat, electricity, freezing, or microwaves.

Ablation can be done in a doctor's office. Or it may be done in a hospital. It usually takes less than an hour. You can go home after the procedure.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• You probably can return to work on the day after the procedure.
• You may shower and take baths as usual.
• Ask your doctor when it is okay for you to have sex or use tampons. Do not douche.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• You may notice that your bowel movements are not regular right after the procedure. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Other instructions

• You may have some light vaginal bleeding. Wear sanitary pads if needed.
• You may want to use a heating pad on your belly to help with pain. Use a low heat setting.
• Talk with your doctor about birth control. Endometrial ablation usually causes infertility, but pregnancy may still be possible. And the pregnancy could have severe problems.

Most people who have endometrial ablation are pleased with the results. It usually reduces menstrual bleeding or stops periods altogether.

But in some cases, more treatment may be needed several years after endometrial ablation. If you're younger, you are more likely to need a repeat procedure.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Problems that can happen during endometrial ablation include:

• Accidental puncture (perforation) of the uterus.
• Infection of the uterus, fallopian tubes, or ovaries (pelvic infection).
• Bleeding (hemorrhage).
• Blood collecting in the uterus (hematometra).
• Tearing of the opening of the uterus (cervical laceration).

These problems are uncommon but can be severe.

After the procedure, you may have some side effects, such as cramping, nausea, and vaginal discharge that may be watery and mixed with blood. This discharge will become clear after a couple of days. It can last for around 1 to 2 weeks.

It takes a few days to 2 weeks to recover. You will probably go home the same day.

Endometrial ablation is a procedure to treat very heavy menstrual bleeding or other abnormal bleeding in the uterus. During ablation, your doctor used a device to destroy the lining of your uterus. The lining heals by scarring. The scarring reduces or prevents bleeding.

You may have cramps and vaginal bleeding or spotting for several days. You may also have watery vaginal discharge for around 1 to 2 weeks.

It may take a few days to 2 weeks to recover.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the doctor's office or hospital

• Bring a picture ID.
• You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep.
• The procedure will take less than an hour.

Endometrial ablation is used to control heavy, prolonged uterine bleeding when:

• Bleeding has not responded to other treatments.
• You don't plan to get pregnant in the future.
• You prefer not to have a hysterectomy to control bleeding.
• Other medical problems prevent a hysterectomy.