Endometrial ablation

What is endometrial ablation?

Endometrial ablation is a surgical treatment for women who have heavy periods. This is an effective treatment for heavy periods. Endometrial ablation is a quick procedure, usually taking no more than 45 minutes, including the time needed for anaesthesia and waking up afterwards. There are several different types of endometrial ablation. The main ones are listed below.

Radiofrequency. A probe is inserted into your womb through your cervix, which sends radiofrequency energy into the lining of your womb. The energy and heat destroy the lining. There is also a gentle suction to remove it.

Heated balloon. A balloon is placed into your womb using a hysteroscope. Heated fluid is then put into the balloon, which grows until it touches the lining of your womb. The heat from the balloon destroys your womb lining.

Electrosurgery. A device called a resectoscope is inserted into your womb through your cervix. The resectoscope has an electrical wire loop, roller-ball, or spiked-ball tip that destroys the lining. This technique is usually done under general anaesthesia, which means you’ll be asleep during the procedure.

Why will I choose endometrial ablation?

There are other options available if endometrial ablation isn’t right for you. For example, you might be offered an intrauterine system (IUS). This is a hormone coil, placed in your womb. It works by thinning the lining of your womb and reducing the bleeding. Other options include medicines such as the combined oral contraceptive pill or tranexamic acid.

If all other treatment options have failed, you may be offered a hysterectomy to remove your womb. But this should be a final option because there is more risk of complications compared with endometrial ablation.

What are the advantages and the risks of endometrial ablation?

Like many procedures, there are pros and cons of endometrial ablation. The advantages are that, it is minimally invasive, non-hormonal treatment which is more effective than medical treatment.

The possible complications of any operation include an unexpected reaction to the anaesthetic. The surgical risks are in the form of infection, damage to your cervix or vagina and rarely damage to womb, bladder or bowel.

Do I need to get admitted for the procedure?

Endometrial ablation is usually done as a day-case procedure, which means you can go home the same day. Depending on the type of ablation you have, you may have the operation done under either local or general anaesthesia.

What to expect after the procedure?

After general anaesthesia, you may feel nauseous and find that you’re not so coordinated or unable to think clearly. This is normal after general anaesthesia and should pass within 24 hours.

You may have a dull ache, like period cramps/pain, for a couple of days after your endometrial ablation. You may be given some pain relief medicine when you leave the hospital. If you need pain relief at home, you can take painkillers such as paracetamol or ibuprofen.

You may have some vaginal bleeding for a few days and a watery discharge for up to three to four weeks. If your discharge becomes smelly or changes colour, or if you have pain and feel unwell, contact your GP or your surgeon because you may have an infection. Use sanitary towels rather than tampons for three or four weeks after having endometrial ablation to help lower your risk of infection.

Wait for three or four weeks until you have sex to reduce your risk of infection.

You’ll be asked to come back for a follow-up appointment, which can be any time between two and six weeks after you’ve had the procedure.

You will most likely have lighter periods after endometrial ablation. You may even stop having periods altogether. However, there is a chance that some women won’t see any change. If the procedure doesn’t help control your bleeding, you may need further treatment.

Becoming pregnant after having endometrial ablation is unlikely, but still possible. However, you’re at an increased risk of miscarriage and other complications if you do become pregnant. You will need to use contraception after the procedure until you have been through the menopause. Alternatively, you may want to consider sterilization. This is a permanent method of contraception and can be done at the same time as endometrial ablation.