A procedure called endometrial ablation destroys the endometrium — the lining of your uterus — with the goal of reducing your menstrual flow. In some women, menstrual flow may stop completely. No incisions are needed for endometrial ablation. Your doctor inserts slender tools through your cervix — the passageway between your vagina and your uterus.
The tools vary, depending on the method used to destroy the endometrium. Some types of endometrial ablation use extreme cold, while other varieties depend on heated fluids, microwave energy or high-energy radiofrequencies.
Some types of endometrial ablation can be done in your doctor’s office, while others must be performed in an operating room. Factors such as the size and condition of your uterus will help determine which endometrial ablation method is most appropriate.
Each month during menstruation, you shed the lining (endometrium) of your uterus. Endometrial ablation treats excessive menstrual blood loss, which may be indicated by:
Unusually heavy periods most months
Enough blood loss to soak through a pad or tampon every hour on the heaviest days
Anemia from excessive blood loss
Several options exist to help reduce menstrual bleeding. Doctors may prescribe medications or a progesterone-releasing intrauterine device (IUD) as the first line of treatment for heavy menstrual bleeding, but endometrial ablation may be an option if medications or an IUD don’t help.
Endometrial ablation is not recommended for women who:
Wish to become pregnant in the future
Have significant cramping with menstrual periods
Have cancer of the uterus
Were recently pregnant
Are past menopause
Many of the newer methods of endometrial ablation can be performed in your doctor’s office. But some types of endometrial ablation are performed in a hospital, especially if you will need general anesthesia.
The opening in your cervix needs to be dilated to allow for the passage of the instruments used in endometrial ablation. Dilation of your cervix can happen with medication or the sequential insertion of a series of rods that gradually increase in diameter.
After endometrial ablation, you may experience:
Cramps. You may have menstrual-like cramps for a few days. Over-the-counter medications such as ibuprofen or acetaminophen can help relieve cramping after the procedure.
Vaginal discharge. A watery discharge, mixed with blood, may occur for a few weeks. The discharge is typically heaviest for the first few days after the procedure.
Frequent urination. You may need to pass urine more often during the first 24 hours after endometrial ablation.
You may need to avoid intercourse and tampon use for a period of time after the procedure.
It may take a few months to see the final results, but endometrial ablation usually succeeds in reducing the amount of blood lost during menstruation. Most women will have lighter periods, and some will stop having periods entirely.
Continue to use contraception, though, because endometrial ablation isn’t a sterilization procedure. Pregnancy may still be possible, but it will likely be hazardous and end in miscarriage.