Endometrial Ablation
A minimally invasive treatment option for women with heavy or prolonged menstrual bleeding when medication has not provided enough relief.
When heavy periods interfere with everyday life
Heavy menstrual bleeding can affect work, sleep, exercise, relationships, and overall quality of life. When bleeding is persistent or unusually heavy, it may also contribute to iron-deficiency anemia and fatigue.
Endometrial ablation is a gynecologic procedure that removes or destroys the lining of the uterus, called the endometrium. The goal is to reduce menstrual bleeding. For some women, periods may become much lighter or stop altogether.
Endometrial ablation is not appropriate for everyone. A careful evaluation is important to determine the cause of abnormal bleeding and whether another treatment would be more appropriate.
Understanding endometrial ablation
Purpose
To reduce heavy or prolonged menstrual bleeding by treating the uterine lining.
Approach
The uterine lining can be treated using different energy-based or thermal techniques.
Pregnancy
Pregnancy after ablation can be dangerous, so reliable contraception is important.
Evaluation
Abnormal bleeding should be evaluated before an ablation procedure is considered.
What is endometrial ablation?
Endometrial ablation is a procedure designed to treat the inner lining of the uterus. Different techniques use heat, radiofrequency energy, heated fluid, or other forms of energy to destroy or remove the endometrial tissue responsible for menstrual bleeding.
Because the uterine lining is treated, the amount of tissue available to shed during menstruation may be reduced.
The uterus and its lining
During a typical menstrual cycle, hormones stimulate the endometrium to thicken in preparation for a possible pregnancy. If pregnancy does not occur, the lining is shed during menstruation.
Endometrial ablation changes this process by treating the lining of the uterus. The procedure is therefore primarily intended for women who have completed childbearing.
Who may be a candidate for endometrial ablation?
Suitability depends on the cause of bleeding, reproductive plans, uterine anatomy, medical history, and previous treatments.
Heavy menstrual bleeding
Bleeding that is unusually heavy, prolonged, or disruptive to daily activities may warrant evaluation.
Completed childbearing
Ablation is generally intended for women who do not want future pregnancies.
Medication has not been enough
Ablation may be discussed when appropriate medical treatment has not adequately controlled bleeding.
Appropriate uterine anatomy
The uterus and uterine cavity need to be evaluated before the procedure.
Signs your menstrual bleeding may need evaluation
Menstrual bleeding varies from person to person. Certain patterns, however, can indicate that an evaluation is appropriate.
Very heavy flow
Bleeding that requires frequent changing of pads or tampons may be considered unusually heavy.
Prolonged periods
Menstrual bleeding lasting longer than expected may warrant medical evaluation.
Large blood clots
Passing large clots, particularly together with heavy bleeding, can be a reason to seek evaluation.
Bleeding between periods
Bleeding outside your expected menstrual cycle should be discussed with an OB/GYN.
Fatigue
Heavy menstrual bleeding can contribute to iron deficiency and anemia.
Daily-life disruption
Menstrual bleeding that interferes with work, exercise, sleep, or normal activities deserves attention.
Heavy bleeding can have many causes
Endometrial ablation treats the uterine lining, but it does not treat every possible cause of abnormal uterine bleeding. Identifying the underlying cause is an important part of treatment planning.
Uterine fibroids
Noncancerous growths in or around the uterus can contribute to heavy menstrual bleeding.
Adenomyosis
Tissue similar to the uterine lining can grow into the muscular wall of the uterus and contribute to painful or heavy periods.
Polyps
Uterine or cervical polyps can cause irregular or heavy bleeding.
Hormonal changes
Changes in reproductive hormones can affect the regularity and amount of menstrual bleeding.
Bleeding disorders
Certain medical conditions that affect blood clotting can contribute to heavy menstrual bleeding.
Endometrial abnormalities
Changes in the uterine lining may require additional evaluation before treatment.
Evaluation comes first
A thorough evaluation helps determine why you are experiencing heavy bleeding and whether endometrial ablation is an appropriate option.
Medical history
Your menstrual pattern, symptoms, medications, medical history, and reproductive plans may be reviewed.
Pelvic examination
A pelvic examination may help identify physical findings that could contribute to abnormal bleeding.
Imaging
Ultrasound or other imaging may be used to evaluate the uterus and identify fibroids, polyps, or other abnormalities.
Endometrial evaluation
Depending on your age, symptoms, and medical history, an endometrial biopsy or other evaluation may be recommended.
How endometrial ablation works
Preparation
Your clinician will review the procedure, medical history, medications, and preparation instructions.
Access to the uterus
A specialized instrument is guided through the vagina and cervix to reach the uterine cavity.
Treatment of the lining
The selected ablation technique treats the endometrial lining using the technology appropriate for your situation.
Recovery
You will receive instructions regarding activity, medications, expected symptoms, and when to contact the office.
Different methods of endometrial ablation
Several techniques can be used to treat the endometrial lining. The appropriate method depends on the patient, uterine anatomy, available technology, and clinical circumstances.
Radiofrequency energy
A specialized device delivers radiofrequency energy to treat the uterine lining.
Thermal balloon
A balloon placed inside the uterus can use heated fluid to treat the endometrium.
Heated fluid
Some techniques use heated fluid within the uterine cavity to treat the lining.
Other technologies
Other ablation approaches may be available depending on the clinical setting and individual circumstances.
Why some women choose endometrial ablation
Less menstrual bleeding
The primary goal is to reduce the amount of menstrual bleeding.
Less disruption
Reducing heavy bleeding may make everyday activities easier for some women.
Alternative to major surgery
For appropriately selected patients, ablation may provide an alternative to more extensive surgical treatment.
Outpatient treatment
Many ablation procedures can be performed without an overnight hospital stay, depending on the specific procedure and patient circumstances.
What results can you expect?
The response to endometrial ablation varies. Some women experience substantially lighter periods, while others continue to have some menstrual bleeding.
Some women eventually stop having periods, but this should not be assumed or guaranteed.
Your individual result depends on several factors
- The cause and severity of your bleeding
- The condition and shape of the uterus
- The thickness and characteristics of the uterine lining
- The ablation technique used
- Age and hormonal status
- Other gynecologic conditions
Risks and possible complications
Endometrial ablation is generally considered a safe procedure for appropriately selected patients, but every medical procedure has potential risks.
Possible risks may include
- Cramping or pelvic discomfort
- Nausea or temporary fatigue
- Vaginal discharge or bleeding during recovery
- Infection
- Bleeding
- Injury to the uterus or nearby organs
- Fluid-related complications with certain techniques
- Incomplete or unsuccessful treatment
- Persistent or recurrent abnormal bleeding
Pregnancy after endometrial ablation is uncommon but can occur and may involve serious risks to the pregnant person and fetus.
Endometrial ablation is not birth control. Appropriate contraception should be used after the procedure, and your clinician can discuss the options that are appropriate for you.
Alternatives to endometrial ablation
Ablation is only one option for treating heavy menstrual bleeding. Your treatment plan should be based on the cause of bleeding, your health, reproductive goals, and personal preferences.
Medication
Hormonal and non-hormonal medications may help control heavy menstrual bleeding for some patients.
IUD
Certain hormonal intrauterine devices can reduce menstrual bleeding and may be an appropriate option for some women.
Hysteroscopic treatment
Polyps or certain fibroids may sometimes be treated through hysteroscopic procedures.
Myomectomy
When fibroids are contributing to symptoms, removing the fibroids may be considered.
Hysterectomy
Hysterectomy permanently removes the uterus and may be considered in certain circumstances.
Endometrial ablation FAQ
Have questions about heavy periods, the procedure, recovery, or whether ablation may be appropriate for you?
Speak With Our OfficeWhat is endometrial ablation?
Endometrial ablation is a procedure that treats the lining of the uterus to reduce heavy menstrual bleeding. Different technologies can be used depending on the patient and clinical setting.
Why is endometrial ablation performed?
It is primarily performed to treat heavy menstrual bleeding when other treatments have not provided sufficient relief or when an appropriately selected patient wants a procedural treatment option.
Will endometrial ablation stop my period?
Not necessarily. Some women experience much lighter periods, while others may eventually stop menstruating. Results vary from person to person.
Is endometrial ablation a form of birth control?
No. Endometrial ablation is not birth control. Pregnancy can still occur after the procedure and can be dangerous, so effective contraception is important.
Can I have children after endometrial ablation?
Endometrial ablation is generally intended for women who do not plan future pregnancies. Pregnancy after ablation can carry serious risks.
How long does endometrial ablation take?
Procedure time varies depending on the technique and individual circumstances. Your clinician can explain the expected duration for the specific procedure being considered.
Is endometrial ablation painful?
Some women experience cramping or pelvic discomfort during or after treatment. Pain management depends on the procedure and the type of anesthesia or sedation used.
How long does recovery take?
Recovery varies depending on the technique and individual health. Your care team will provide specific instructions about activity, medications, intercourse, bathing, and returning to normal activities.
Can endometrial ablation treat fibroids?
Ablation may not be appropriate when fibroids significantly alter the uterine cavity. The type, size, and location of a fibroid are important when choosing treatment.
Can I have an ablation if I have an IUD?
This depends on the type of IUD and the planned procedure. Your OB/GYN should determine whether the IUD needs to be removed or whether another treatment is more appropriate.
Can heavy bleeding return after ablation?
Yes. Although many women experience reduced bleeding, symptoms can persist or return. Additional treatment may sometimes be necessary.
Is endometrial ablation better than hysterectomy?
Neither treatment is universally better. They are different procedures with different benefits, risks, recovery considerations, and implications for future pregnancy. Your OB/GYN can help compare the options based on your circumstances.
You don't have to live with heavy periods.
If heavy or prolonged menstrual bleeding is affecting your quality of life, an OB/GYN evaluation can help identify the cause and discuss appropriate treatment options.