This procedure involves the surgical removal of the lining of the uterus (womb). It may involve using heat, cold temperatures, microwave energy, or other methods.
Endometrial ablation will likely make menstrual flow lighter. In some cases, it stops menstrual flow completely. The procedure is used to treat
—recurrent heavy periods not controlled by medication.
Talk to your doctor about your plans for having a baby. This procedure decreases your chance of pregnancy.
Complications are rare, but no procedure is completely free of risk. If you are planning to have endometrial ablation, your doctor will review a list of possible complications, which may include: InfectionBleedingComplications related to anesthesiaUterine perforation or organ injuryEdema (swelling) due to fluid leakage and absorptionThermal (heat) injury to the vagina, vulva, or bowel
If you have a history of painful periods or tubal sterilization, you may also be at risk for developing new or worsening pain after this procedure.
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as: SmokingDrinkingChronic disease such as diabetes or obesity
The following may also increase your risk of complications: Pregnancy or possible pregnancy—procedure should not be done if there is a chance that you are pregnant
pelvic inflammatory disease
(PID)—may trigger a recurrence of PID
Inflammation of the cervix
Prior to the procedure, your doctor will likely:
of your uterus to check for abnormalities and understand the shape and size of your uterus.
Your medical historyMedications or herbs and supplements you takeAny allergies you haveWhether you are pregnant or trying to get pregnantIf you have an intrauterine device (IUD)
Before the procedure, you may need to: Ask your doctor about your options. There are many types of endometrial ablation.
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
Take medication to thin the lining of the uterus.Arrange for someone to drive you home from the care center. You may also need help at home.
The day before the procedure: Have a light dinner.The night before, do not eat or drink anything after midnight.
There are three anesthesia options for ablation: General anesthesia
—blocks pain and keeps you asleep through the procedure
—blocks pain in the area, but you stay awake through the procedure; given as an injection
Local anesthesia—just the area that is being operated on is numbed; given as an injection
Your doctor will help you decide which one is right for you.
There are many different ways for the doctor to do this procedure. A simple ablation procedure is short. It can often be done in a care center. Other procedures take longer and need to be done in a hospital.
During the procedure, the doctor will not make any incisions to access the uterus. A tiny probe will be inserted through the vagina and into the uterine cavity through the cervix. Depending on the method, the tip of the probe will expand to deliver: Radiofrequency—heat and energyCryoablation—freezing temperatureHeated fluidHeated balloonMicrowave energyElectrosurgery—uses electrical current and a heated rollerball or spiked ball); may require general anesthesia
These methods will destroy the cells lining the uterine cavity. You will not feel pain. Often, ultrasound is used to help guide the doctor. Suction will be used to remove the tissue that has been destroyed.
This depends on the type of method. It can take 15-45 minutes or longer.
You may feel cramping and discomfort. Your doctor will give you pain medication.
This is usually done on an outpatient basis. You may need to stay there for 1-2 hours. Some methods may require an overnight hospital stay.
While recovering, the hospital staff may: Check blood pressure, heart rate, and breathingCheck on your fluid status and the electrolytes in your blood
During your stay, the hospital staff will take steps to reduce your chance of infection such as: Washing their handsWearing gloves or masks
There are also steps you can take to reduce your chances of infection such as: Washing your hands often and reminding visitors and healthcare providers to do the sameReminding your healthcare providers to wear gloves or masks
Your doctor will ask you how you feel and make sure you are well enough to go home.
When you return home, do the following to help ensure a smooth recovery: Talk to your doctor about how your fertility has been affected by the procedure. Discuss family planning options.
Have pelvic exams.
After you leave the hospital, call your doctor if any of the following occurs: Heavy vaginal bleedingSevere abdominal cramping and pelvic painSevere pain during sexSevere low back painPain during bowel movements or urinationSigns of infection, including fever and chillsNausea and vomitingCough, chest pain, or shortness of breathLightheadednessPain or tenderness in the calf or legMenstruation does not get lighter after 2-3 periods
In case of an emergency, call for emergency medical services right away.
Endometrial ablation. AHRQ National Guideline Clearinghouse website. Available at:
http://www.guideline.gov/summary/summary.aspx?doc_id=10918&nbr=5698&ss=6&xl=999. Updated May 2007. Accessed September 23, 2014.
Endometrial Ablation. The American College of Obstetricians and Gynecologists, Practice bulletin. No. 81, May 2007.
Endometrial ablation. The American College of Obstetricians and Gynecologists website. Available at:
http://www.acog.org/Patients/FAQs/Endometrial-Ablation. Published April 2013. Accessed September 23, 2014.
Heavy menstrual bleeding. National Institute for Health and Clinical Excellence website. Available at:
http://www.nice.org.uk/nicemedia/pdf/CG44NICEGuideline.pdf. Published January 2007. Accessed September 23, 2014.
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. Updated August 23, 2005. Accessed September 23, 2014.
Patient fact sheet: endometrial ablation. American Society for Reproductive Medicine website. Available at:
http://www.asrm.org/FACTSHEET_Endometrial_Ablation/. Updated 2011. Accessed September 23, 2014.
4/6/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Wishall KM, Price J, et al. Postablation risk factors for pain and subsequent hysterectomy. Obstet Gynecol. 2014 Nov; 124(5):904-910.
Last reviewed August 2014 by Andrea Chisholm, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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