What Is an Endometrial Ablation?

Endometrial or uterine ablation is a medical procedure for removing or destroying the endometrium, which is a tissue layer on the inside of the uterus. The procedure can be performed using a variety of different methods, generally without surgery or anesthesia. Most women receiving an endometrial ablation do so to remedy health issues related to unusually heavy or prolonged menstruation. Though not categorized as a sterilization procedure, endometrial ablation greatly reduces the likelihood of a healthy pregnancy. There are cases in which the endometrial lining grows back, especially in younger women.

Endometrial ablation has proven effective in addressing excessive menstrual blood loss but carries with it serious implications for women who want to conceive children. To learn more about endometrial ablation and how it is conducted, contact your gynecologist at Baptist Health.

When Is This Procedure Performed?

Endometrial ablations are primarily a treatment for women who experience heavy or prolonged menstrual bleeding, according to the following criteria:

• Bleeding that soaks a tampon or pad in two hours’ time or less
• A menstrual period that runs eight days or longer
• Bleeding that occurs between periods
• Anemia resulting from excessive menstrual blood loss.

An endometrial ablation is usually performed only when less invasive treatments, such as prescription medications and intrauterine devices (IUDs), fail to control menstrual bleeding. Ablations are not appropriate in every circumstance. Postmenopausal women and individuals with pelvic infections or uterine cancers are not good candidates for this procedure.

How Do I Prepare for an Endometrial Ablation?

In the run-up to the ablation procedure, your gynecologist may schedule several preparatory tests or operations:

• Pregnancy check: Ablation cannot be performed on a pregnant woman.
• Cancer check: A sample of endometrial tissue will be analyzed for cancer.
• IUD removal: An IUD must be removed prior to ablation.
• Dilation and curettage (D&C): Endometrial ablations are more successful when the uterine lining is relatively thin. Thinning can be accomplished with a dilation-and-curettage procedure.

If you’re interested in having children, but don’t feel that you can delay the ablation procedure, talk to a fertility specialist beforehand. He or she can advise you on your options, including oocyte cryopreservation (egg freezing), surrogacy, and adoption.

What Should I Expect During This Procedure?

An ablation procedure begins with the insertion by your gynecologist of a device for widening the cervix. This allows him or her to situate one of several types of ablation instruments inside the uterus. Among these instruments are:

• Thermal balloon: A balloon is inflated with a hot liquid that destroys the endometrial lining. This method takes up to 12 minutes to be effective.
• Thermal liquid: A hot liquid can also be injected directly into the uterus. It circulates inside the organ for about ten minutes before being evacuated.
• Cryoablation (freezing): A small probe, guided by an ultrasound device, uses extreme cold to eliminate the endometrium. The time involved depends on the configuration of the uterine cavity.
• Microwave: This type of probe utilizes microwaves to destroy the uterine lining. It accomplishes this in three to five minutes.
• Radiofrequency: Another type of probe emits electrical energy at the frequency of 350-500 kHz. This method can vaporize the endometrium in one to two minutes.
• Electrosurgery: Electrosurgery combines an endoscopic device with a heat element to remove endometrial tissue. This method requires a general anesthesia.

What Should I Expect After This Procedure?

Following the procedure, you’ll likely spend several hours recuperating in the hospital or operating facility. This is especially true if you had general anesthesia. Arrange to have someone take you home, when you’re released by your gynecologist. 

You may temporarily experience:

• Nausea
• Increased urination
• Cramping
• A watery or bloody discharge.

More serious symptoms – fever, chills, heavy bleeding, and severe cramping – are causes for concern. Contact your gynecologist or seek emergency care.

What Are Possible Side Effects of an Endometrial Ablation?

The chief possible side effect of endometrial ablation is the loss of fertility and an increased risk of abnormal pregnancy, if conception does occur. Other less-likely risks include:

• Infection
• Uterine wall punctures
• Damage to the vulva, vagina, or bowels
• Absorption by the body of fluids introduced during the procedure.

An additional complication is called late-onset endometrial ablation failure. This involves the abnormal regrowth of the endometrium in the months or years following the procedure.

What Results Should I Expect from an Endometrial Ablation?

Recovery times vary, depending on how the ablation was performed and the degree of difficulty involved. Your periods should diminish gradually, eventually stopping altogether. Because your reproductive organs remain intact, pregnancy, though unlikely, remains a possibility. Unless you undergo a sterilization procedure, you should utilize some form of birth control while sexually active.

Learn More About Endometrial Ablations at Baptist Health

For more information about endometrial ablations, or to schedule an appointment with our gynecologists, please contact your Baptist Health gynecologist.