Endometrial ablation is a procedure performed by your gynecologist to address heavy and abnormal menstrual cycles. The procedure destroys the endometrial tissue − this is the inner uterine lining from which menstruation (your period) happens. The goal of ablation is to return your menstrual cycles to normal or lighten your menstrual period. Often, this procedure is successful and can stop periods completely in some patients.
It is common to try medication first to control heavy and irregular bleeding. If medication is not successful, you and your provider may consider this procedure. Endometrial ablation does not affect a woman’s hormone levels and will not cause her to have menopause earlier. It is simply a tool to improve the menstrual cycle by treating the source of bleeding, the inner uterine lining.
It is expected that you and your doctor would discuss the appropriateness of this procedure and if you are a good candidate for it. Patients that may not be a candidate for endometrial ablation include those with concern for cancer of the uterus or those we are concerned of a recent infection of the inner uterine lining. It is especially important to discuss future pregnancy when considering this procedure − once the endometrial ablation is performed, it becomes very problematic and potentially dangerous to become pregnant. Reliable contraception is needed after endometrial ablation until menopause.
How is endometrial ablation performed?
The procedure is performed in an operating room or outpatient setting. Your provider will examine the inner uterine lining by hysteroscopy (a lighted camera) and may take tissue samples (biopsies). The cervix is dilated to allow an instrument that uses either radiofrequency, heated fluid, steam, balloon or electrosurgery to destroy the endometrial tissue. Radiofrequency is the most common. Your provider will discuss the method used prior to your procedure.
The procedure generally does not take very long. This is an outpatient surgery, meaning once your initial recovery is over, you can continue recovering at home. Depending on the method used, cramping, discharge and some bleeding typically occurs as part of the expected recovery. You and your doctor will discuss when you can resume normal activities, including sex and exercise.
Expect a follow-up appointment a few weeks after surgery. The effect of the ablation on your menstrual cycle will evolve over several months.
This procedure may be right for you to help address your heavy or abnormal menstrual bleeding. Discuss this and other options for care with your Kelsey-Seybold OB/GYN provider.