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Endometrial Ablation

Surgery Overview

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.

What To Expect

After the procedure, you may have some side effects, such as cramping, nausea, and vaginal discharge that may be watery and mixed with blood. This discharge will become clear after a couple of days. It can last for around 1 to 2 weeks.

It takes a few days to 2 weeks to recover. You will probably go home the same day.

Why It Is Done

Endometrial ablation is used to control heavy, prolonged vaginal bleeding when:

  • Bleeding has not responded to other treatments.
  • Child-bearing is completed.
  • You prefer not to have a hysterectomy to control bleeding.
  • Other medical problems prevent a hysterectomy.

How Well It Works

Most women will have reduced menstrual flow after an endometrial ablation. And up to half will stop having periods.footnote 1

The procedure is less likely to work in younger women than in older women. After an endometrial ablation, younger women are more likely to still have periods and need a repeat procedure.

Young women may be treated with gonadotropin-releasing hormone analogues (GnRH-As) 1 to 3 months before the procedure. This will decrease their production of estrogen and help thin the lining of the uterus (endometrium).

Risks

Problems that can happen during endometrial ablation include:

  • Accidental puncture (perforation) of the uterus.
  • Burns (thermal injury) to the uterus or the surface of the bowel.
  • Buildup of fluid in the lungs (pulmonary edema).
  • Sudden blockage of arterial blood flow within the lung (pulmonary embolism).
  • Tearing of the opening of the uterus (cervical laceration).

These problems are uncommon but can be severe.

Related Information

References

Citations

  1. Fritz MA, Speroff L (2011). Abnormal uterine bleeding. In Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 591–620. Philadelphia: Lippincott Williams and Wilkins.

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