Endometrial ablation
What is an endometrial ablation?
Endometrial ablation is a minimally invasive procedure used to treat heavy menstrual bleeding.
The procedure removes or destroys the lining of the uterus (the endometrium), reducing or stopping menstrual bleeding. Because the endometrial lining is responsible for menstrual periods, removing the deeper layer prevents the lining from regrowing normally each month.
Endometrial ablation is only suitable for women who have completed their family, as pregnancy after the procedure is not recommended.
Why might I need an endometrial ablation?
Endometrial ablation is performed to reduce heavy menstrual bleeding that has not responded adequately to other treatments.
Many women choose this procedure when heavy periods are affecting their quality of life, work, exercise or daily activities.
Your specialist will discuss whether endometrial ablation is appropriate for you based on your symptoms, age and future pregnancy plans.
How is the procedure performed?
The procedure is performed through the vagina and cervix, so no abdominal incisions are required.
A hysteroscope (a thin telescope) is passed into the uterus to examine the uterine cavity before treatment begins.
Depending on the technique used, the lining of the uterus is treated by either:
- removing the deeper layer of the endometrium (endometrial resection), or
- using a specialised single-use device to destroy the lining with controlled energy (endometrial ablation).
Both techniques aim to prevent the lining from regenerating normally each month.
The procedure itself usually takes around 15 minutes, although your total time in theatre and recovery will be several hours.
Preparing for your procedure
Endometrial ablation is usually performed under a general anaesthetic.
Before your procedure:
- complete any investigations requested by your specialist
- continue your usual medications unless advised otherwise
- follow the fasting instructions provided by your hospital
- let your specialist know if you become unwell before your surgery.
Your healthcare team will explain exactly what to expect on the day of your procedure.
What should I expect after the procedure?
After the procedure, you will recover in the recovery area before returning to the ward.
Most women are able to return home later the same day.
It is normal to experience:
- mild pelvic cramping
- light vaginal bleeding or watery discharge
- mild fatigue following the anaesthetic.
If required, your specialist will prescribe pain relief, although many women find simple pain medication is sufficient.
After discharge from hospital, you should:
- eat and drink normally
- remain mobile
- use sanitary pads (not tampons) if required
- shower normally
You should not:
- have intercourse for two weeks
- undertake any unsupervised activity on the day of the procedure because of the effects of the anaesthetic.
You should be able to return to work within a few days.
How effective is endometrial ablation?
Endometrial ablation is an effective treatment for heavy menstrual bleeding.
For approximately 90% of women, menstrual bleeding either stops completely or becomes significantly lighter and more manageable.
In around 10% of cases, symptoms may persist and further treatment may be required.
Your specialist will discuss whether endometrial ablation is the most appropriate option for your individual circumstances.
What if I have any problems?
You should notify your healthcare practitioner with the following problems:
- fever or feeling unwell
- offensive vaginal discharge or heavy bleeding
- intractable nausea or vomiting
- severe pain
What are the risks?
Every surgical procedure carries some risk, although serious complications following endometrial ablation are uncommon.
Your specialist will discuss the potential risks and benefits before your procedure, including those specific to your medical history.
When should I seek medical advice?
Contact your healthcare provider promptly if you experience:
- fever or feel generally unwell
- heavy vaginal bleeding
- offensive-smelling vaginal discharge
- severe pelvic pain
- persistent nausea or vomiting.
These symptoms may indicate infection or another complication that requires medical review.
What can I expect?
Most women recover quickly following endometrial ablation and return to normal daily activities within a few days.
The full effect of the procedure may take several months to become apparent as the uterine lining heals and menstrual bleeding settles.
While many women experience a significant reduction in bleeding, individual outcomes vary, and some women may require additional treatment in the future.
What to remember
Endometrial ablation is a minimally invasive treatment designed to reduce heavy menstrual bleeding in women who have completed their family.
For most women, it provides significant and lasting improvement in menstrual symptoms while avoiding more invasive surgery such as hysterectomy. Your specialist will help determine whether this procedure is the right option for you.
Further information
Read the report below to ensure you are fully informed on the endometrial ablation procedure:
ranzcog.edu.au/wp-content/uploads/2022/06/Endometrial-Ablation.pdf
This article is intended for educational purposes only and should not replace personalised medical advice, diagnosis or treatment. Every article is written by a qualified specialist clinician and independently reviewed by a second specialist clinician to help ensure clinical accuracy and reflect current evidence-based practice.
