What is endometrial ablation?

Endometrial ablation is a procedure to treat very heavy menstrual bleeding or other abnormal bleeding in the uterus. During ablation, the lining of the uterus is destroyed. The lining heals by scarring. The scarring reduces or prevents bleeding.

During the procedure, your doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads apart the sides of your vagina. Your doctor may use a lighted tube (called a hysteroscope, or scope) through the cervix to see inside the uterus. A device that uses either a laser beam, heat, electricity, freezing, or microwaves will be inserted to destroy the lining.

Your doctor may give you medicine to help you relax. You may also be given medicine to help with pain.

The procedure can be done in a doctor's office or a hospital. It usually takes less than an hour. You will go home after the procedure.

This procedure is not recommended if you plan to get pregnant.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before the procedure?

Having a procedure can be stressful. This information will help you understand what you can expect and how to safely prepare for your procedure.

Preparing for the procedure

• Bring a list of questions to ask your doctors. It is important that you understand exactly what procedure is planned, the risks, benefits, and other options before your procedure.
• Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia. Your doctor will tell you which medicines to take or stop before your procedure.
• If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your procedure. Make sure that you understand exactly what your doctor wants you to do.
• You may need to stop taking certain medicines a week or more before your procedure, so talk to your doctor as soon as you can.
• Before your procedure, you may speak with an anesthesia provider to discuss your anesthetic options, including the risks, benefits, and alternatives to each. This may be on the phone or in person.

Taking care of yourself before the procedure

• Build healthy habits into your life. Changes are best made several weeks before the procedure, since your body may react to sudden changes in your habits.
  • Stay as active as you can.
  • Eat a healthy diet.
  • Cut back or quit alcohol and tobacco.
• If you have an advance care plan, let your doctor know. If you do not have one, you may want to prepare one so your doctor and loved ones know your health care wishes. Doctors recommend that everyone prepare these papers before a procedure, regardless of the type of procedure or condition.

What happens on the day of the procedure?

• Follow the instructions exactly about when to stop eating and drinking, or your procedure may be cancelled. If your doctor has instructed you to take your medicines on the day of the procedure, please do so using only a sip of water.
• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Remove all jewellery, piercings, and contact lenses.
• Leave your valuables at home.

At the doctor's office or hospital

• Bring a picture ID.
• A small tube (IV) may be placed in a vein, to give you fluids and medicine to help you relax.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may range from making you fully asleep, to simply numbing the area being worked on. This will depend on the procedure you are having, as well as a discussion between your doctor, the anesthesia provider, and you.
• The procedure will take less than an hour.

Going home

• You may need someone to drive you home.
• For your safety, you should not drive until you are no longer taking pain medicines and you can move and react easily.
• Arrange for extra help at home after the procedure, especially if you live alone or provide care for another person.
• You will be given more specific instructions about recovering from your procedure, including activity and when you may return to work.

When should you call your doctor?

• You have questions or concerns.
• You do not understand how to prepare for your procedure.
• You become ill before the procedure (such as fever, cold or flu, chest pain, or shortness of breath).
• You need to reschedule or have changed your mind about having the procedure.