What is endometrial ablation?

Endometrial ablation is a procedure used to treat heavy menstrual bleeding by removing or destroying (ablating) the lining of your uterus (endometrium), which can reduce or stop menstrual flow. Various techniques may be used to perform the ablation, including radiofrequency, thermal balloon, cryoablation, and microwave energy.

Who is suitable for endometrial ablation?

Endometrial ablation is an option for you if you experience heavy periods (menorrhagia) that interfere with your quality of life and have not responded to other treatments, such as hormonal therapy or medication. It can also serve as an alternative to major surgical procedures like hysterectomy. However, it is not suitable if you wish to have children in the future, as the procedure can significantly reduce fertility. It’s important to note that endometrial ablation is not a contraceptive method, so you should still use effective contraception to prevent pregnancy.

Preparing for the procedure

Before undergoing endometrial ablation, you will have a thorough consultation with your gynaecologist to discuss your symptoms, medical history, and the most suitable treatment option for you. Pre-procedure preparations may include:

• Contraception: You should use adequate contraception in the three weeks prior to the procedure. The procedure cannot be done if you are, or think you may be, pregnant or if you were pregnant in the last six weeks.
• Pelvic examination: A physical examination will assess the size and position of your uterus.
• Ultrasound scan: An ultrasound may be performed to check the condition of your uterus and to rule out other causes of heavy bleeding, such as fibroids.
• Endometrial biopsy: A biopsy may be taken to exclude any abnormal cells in the lining of your uterus.

Endometrial ablation procedure

The procedure may be performed under local or general anaesthetic. If you have a general anaesthetic, you’ll be asleep during the procedure, and you will be given instructions on when to stop eating and drinking, usually from around six hours before your procedure. If local anaesthesia is used, it will block pain and discomfort in your cervix, and you’ll be awake during the surgery.

Endometrial ablation usually takes around 30 minutes and is typically done as a day-case procedure.

Your gynaecologist will pass a thin camera called a hysteroscope through your vagina and cervix to see inside your womb. Fluid is passed into your womb to ensure a clear view.

Various techniques may be used to destroy or remove the lining of your womb. The most common techniques include:

• Radiofrequency: A probe is passed through your cervix into your womb, sending electromagnetic energy into the lining of your womb, which destroys the tissue.
• Heated balloon: A balloon is inserted into your womb, and heated fluid is passed into it, expanding the balloon until it touches the lining of your womb. The heat from the balloon destroys the lining.
• Electrosurgery: A device called a resectoscope is passed through your cervix into your womb. The resectoscope has an electrical wire loop or roller-ball that destroys the lining.

After the procedure

You should be able to go home the same day. It’s advisable to have someone accompany you home.

Recovery and aftercare

After the procedure, you may experience cramping similar to menstrual pain for a few days. Over-the-counter pain relief is usually sufficient to manage this discomfort.

Light bleeding or watery discharge is also common for up to two weeks after the procedure. It’s advisable to avoid using tampons, douching, or having sexual intercourse until the discharge stops to reduce the risk of infection.

Most women can return to their regular activities within a few days, although you may be advised to take it easy for the first 24 hours. Your gynaecologist will provide specific aftercare instructions based on your individual case.

Benefits of endometrial ablation

Endometrial ablation offers several benefits, including:

• Reduction in menstrual bleeding: Many women experience significantly lighter periods or no periods at all following the procedure.
• Minimally invasive: The procedure does not involve major surgery and can often be performed as a day-case, allowing for a quick recovery.
• Quick recovery: Most women can return to their normal activities within a few days.
• Avoidance of hysterectomy: For some women, endometrial ablation provides an alternative to hysterectomy, which is a more invasive surgery with longer recovery times.

Risks and complications

As with any medical procedure, endometrial ablation carries some risks. It’s essential to discuss these with your gynaecologist before deciding on treatment. Potential risks and complications include:

• Infection: There is a small risk of infection following the procedure, which can usually be treated with antibiotics.
• Bleeding: Some women may experience light bleeding or spotting for a few days after the procedure.
• Perforation: There is a very low risk of perforation of the uterus during the procedure, which may require additional treatment.
• Inadequate results: In some cases, the procedure may not effectively reduce menstrual bleeding, and further treatment may be necessary.
• Future pregnancy complications: Although rare, pregnancy after endometrial ablation can be complicated and is associated with increased risks of miscarriage or preterm birth. Therefore, reliable contraception is recommended.

When to seek medical advice

You should contact your gynaecologist or seek medical attention if you experience:

• Severe abdominal pain that is not relieved by painkillers
• Heavy bleeding or discharge with a strong odour
• Fever or signs of infection
• Difficulty passing urine or bowel movements

Why choose Birmingham Gynaecology Clinic?

Birmingham Gynaecology Clinic offers expert endometrial ablation with the latest technology, ensuring effective treatment for heavy menstrual bleeding. Our experienced gynaecologists focus on providing personalised care, prioritising your comfort and well-being throughout the minimally invasive procedure and recovery.

Contact us

For more information or to schedule an appointment, contact Birmingham Gynaecology Clinic. Our team is here to support you with expert care at every step. Reach out today to take control of your gynaecological health.