Definition

Endometrial ablation is the destruction of the lining of the uterus. It may involve using heat, cold temperatures, microwave energy, or other methods.

Reasons for Procedure

Endometrial ablation is used to treat regular heavy periods that cannot be controlled with medicine. It should make menstrual flow lighter. In some cases, it stops menstrual flow completely.

This procedure should not be done if you plan to become pregnant in the future. Talk to your doctor about your plans for having a baby.

Possible Complications

Complications are rare, but no procedure is completely free of risk. The doctor will review a list of possible problems, which may include:

  • Infection
  • Bleeding
  • Complications related to anesthesia
  • Puncture of uterus or organ injury
  • Edema (swelling) due to fluid leakage and absorption
  • Heat injury to the vagina, vulva, or bowel

The risk of new or worsening pain may be higher if there is a history of painful periods or tubal sterilization.

Some things can increase the chance of problems such as:

  • Smoking
  • Drinking
  • Chronic disease, such as diabetes or obesity

The following may also increase the risk of problems:

  • Pregnancy or possible pregnancy—procedure should not be done if there is a chance that you are pregnant
  • History of pelvic inflammatory disease (PID)—may trigger a recurrence of PID
  • Inflammation of the cervix

What to Expect

Prior to Procedure

Previous test results will be reviewed. Prior to the procedure, the doctor will likely ask about:

  • Whether you are pregnant or trying to get pregnant
  • Current intrauterine device (IUD)

The type of ablation will be reviewed. Before surgery:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
  • Arrange for someone to drive you home from the care center. You may also need help at home.

You may need to avoid food and drink after midnight the night before.

Anesthesia

There are 3 anesthesia options for ablation:

The doctor will discuss options.

Description of the Procedure

There are many different ways for the doctor to do this procedure. A simple ablation procedure is short. It can sometimes be done in an office or care center. Other procedures take longer and need to be done in a hospital.

A small probe will be inserted through the vagina. It will be passed into the uterus through the cervix. The tip of the probe will deliver on of the following:

  • Radiofrequency—heat and energy
  • Cryoablation—freezing temperature
  • Heated fluid
  • Heated balloon
  • Microwave energy
  • Electrosurgery—electrical current and a heated rollerball or spiked ball

All methods will destroy the cells lining the uterine cavity. You will not feel pain. An ultrasound may be done at the same time. The doctor will use it to guide the probe. Damaged tissue may be removed with suction.

How Long Will It Take?

This depends on the type of method. It can take 15 to 45 minutes or longer.

How Much Will It Hurt?

Cramping and some discomfort is common after surgery. Pain medicine can help to manage it.

Post-procedure Care

At the Care Center or Hospital

Your doctor will ask you how you feel. You will be able to leave when you feel ready.

At Home

Most can return to normal activity within a few days. Some more intense activity may need to be delayed.

Call Your Doctor

After you leave the hospital, call your doctor if any of the following occurs:

  • Heavy vaginal bleeding
  • Severe abdominal cramping and pelvic pain
  • Severe pain during sex
  • Severe low back pain
  • Pain during bowel movements or urination
  • Signs of infection, including fever and chills
  • Nausea and vomiting
  • Cough, chest pain, or shortness of breath
  • Lightheadedness
  • Pain or tenderness in the calf or leg
  • Menstruation does not get lighter after 2 to 3 periods

In case of an emergency, call for emergency medical services right away.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

American Society for Reproductive Medicine
http://www.asrm.org

CANADIAN RESOURCES:

Canadian Women’s Health Network
http://www.cwhn.ca

Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

REFERENCES:

Endometrial ablation. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T474319/Endometrial-ablation. Updated October 1, 2015. Accessed March 19, 2020.

Endometrial ablation. The American College of Obstetricians and Gynecologists, Practice bulletin. No. 81, May 2007. Obstet Gynecol. 2007 May;109(5):1233-48.

Endometrial ablation. The American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/Patients/FAQs/Endometrial-Ablation. Published July 2017. Accessed March 19, 2020.

Heavy menstrual bleeding. National Institute for Health and Clinical Excellence website. Available at: http://www.nice.org.uk/nicemedia/pdf/CG44NICEGuideline.pdf. Updated August 2016. Accessed March 19, 2020.

Lethaby A, Hickey M, et al. Endometrial destruction techniques for heavy menstrual bleeding. Cochrane Collection website. Available at: http://www.cochrane.org/reviews/en/ab001501.html. Published August 23, 2013. Accessed March 19, 2020.

4/6/2015 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115612/Uterine-leiomyoma: Wishall KM, Price J, Pereira N, Butts SM, Della Badia CR. Postablation risk factors for pain and subsequent hysterectomy. Obstet Gynecol. 2014 Nov; 124(5):904-910.

Last reviewed September 2019 by EBSCO Medical Review Board Mary-Beth Seymour, RN  Last Updated: 9/18/2020