Endometrial Ablation

A minimally invasive procedure to remove the womb lining and reduce heavy menstrual bleeding

Endometrial ablation is a treatment that destroys or removes the lining of the uterus (endometrium) to dramatically reduce menstrual bleeding. It is typically offered to women suffering from heavy periods (menorrhagia) when other treatments like medication or a coil (IUS) have not been effective or are not suitable. The procedure is quick and does not require any incisions, as it is performed via the vagina and cervix. Endometrial ablation can be an excellent alternative to a hysterectomy for women who have completed their families, providing relief from heavy periods with a far shorter recovery time.

Why might you need it?

• Endometrial ablation is commonly recommended for:
• Heavy menstrual bleeding that is impacting your daily life (e.g. very heavy periods or prolonged periods)
• Menorrhagia that has not improved with medication or hormonal intrauterine devices (like the Mirena coil)
• Women who do not plan to have more children and wish to avoid major surgery (such as hysterectomy) for heavy period management

This procedure is only advised when future pregnancy is not desired, because the loss of the uterine lining can complicate carrying a pregnancy. It provides a solution to improve quality of life for women who suffer from troublesome heavy periods.

What does the procedure involve?

• Endometrial ablation is usually performed under local anaesthetic or light sedation, and sometimes under general anaesthetic, often as a day-case. You won’t have any external cuts, since the procedure is done through the vagina.
• A speculum is inserted into the vagina to hold it open, and a slender device is passed through the cervix into the uterus.
• Depending on the technique used, the device will deploy energy to destroy the uterine lining. Methods include heat (for example, a heated balloon or radiofrequency energy), freezing, or microwave energy. Your gynaecologist will choose the method best suited to your situation.
• The treatment itself typically takes only a few minutes once the device is in place. You will not feel pain during the ablation because of the anaesthesia, though you may feel some pressure or cramping. After the lining is treated, the device is removed and the procedure is complete without any stitches needed.

What to expect during recovery
After an endometrial ablation, recovery is generally quick. You may experience cramping, similar to period pains, for a day or two – this can be managed with pain relief like paracetamol or ibuprofen. It’s normal to have light vaginal bleeding and a watery or pinkish discharge for one to two weeks as the uterus heals. During this time, you should avoid inserting anything into the vagina (no tampons and no sexual intercourse) for at least 2 weeks, or as advised by your doctor, to reduce the risk of infection. Most women feel well enough to return to work and normal activities within a couple of days, but listen to your body and rest if needed. A follow-up appointment may be scheduled to check on your recovery. Importantly, after ablation you should continue contraception if pregnancy is not desired, because although unlikely, pregnancy would be risky without a full uterine lining.

What are the benefits?

• Significantly reduces menstrual bleeding – many women have much lighter periods or even stop having periods entirely after ablation
• Quick, day-case procedure with a fast recovery (most resume normal routine within days, versus weeks for major surgery)
• Avoids the need for major surgery like hysterectomy to control heavy bleeding, thus no large incisions or long hospital stay
• High patient satisfaction – by alleviating heavy periods, it can greatly improve daily life, energy levels, and prevent anemia
• Does not affect hormonal balance, and for women who have completed childbearing, it provides long-term relief from heavy menstruation while leaving the uterus in place

If heavy periods are affecting your life and other treatments haven’t helped, endometrial ablation could be an option to consider. We’re here to answer your questions and guide you through the decision-making process. Feel free to reach out to discuss whether this procedure is right for you and to understand the next steps.