Endometrial ablation at a glance
- Endometrial ablation is a procedure to destroy the endometrium, the lining of the uterus, to reduce a woman’s heavy periods.
- In endometrial ablation, a medical device is inserted through the cervix and uses energy, heat or cold to destroy endometrial cells that are causing the abnormally heavy bleeding.
- Endometrial ablation is a very safe procedure, and most women return to normal activity the day after.
- Risks of ablation include bleeding, infection and damage to nearby organs.
What is endometrial ablation?
Endometrial ablation is a short procedure (most procedures last about half an hour) that destroys the uterine lining, known as the endometrium, to lighten or stop a woman’s period entirely. Endometrial ablation requires no incisions and thus produces no scars. A doctor inserts small tools through the cervix into the uterus that destroy the endometrial cells using either energy, heat or cold, depending upon the medical device.
There are a number of brands of tools and devices used to perform endometrial ablation. CU primarily uses the NovaSure device, which uses radiofrequency energy to destroy the endometrial cells. Endometrial ablation requires no pills and produces no hormonal side effects (contrary to a common misconception, patients will not become instantly menopausal with this procedure).
Ninety percent of women who undergo endometrial ablation report a radical reduction in menstrual flow. The procedure is typically performed under sedation so the patient feels no pain and can return to all normal activities the next day. Endometrial ablation is not recommended for women who would like to become pregnant in the future, were recently pregnant, could have endometrial cancer, or have an abnormal appearing uterus (fibroids, septum, etc).
Who should consider endometrial ablation?
Women who experience heavy, life debilitating periods are often good candidates for endometrial ablation. During a woman’s period, the lining of the uterus, the endometrium, sheds and leaves the body. Abnormally heavy periods may be indicated when a woman needs to change her tampon or pad every hour because it’s soaked through with blood.
Heavy periods can negatively impact a woman’s life in many ways. These include physical effects such as fatigue and nausea, painful cramps and headaches. But heavy periods also have social and emotional effects. Many women who experience heavy periods report that they avoid sex, experience anxiety and report a lack of confidence as a result of heavy periods.
If a woman has failed medical therapy with hormones, she may also be a good candidate. Not every woman wants a hysterectomy to address her heavy bleeding, and this procedure with a short recovery period works well for many women.
Risks & considerations of endometrial ablation
Although endometrial ablation is safe, there are some risks to consider before undergoing the procedure. These include the possibility of a puncture injury (perforation) on the wall of the uterus caused by the surgical devices.
The energy, heat or cold created by the devices may also, in rare cases, cause damage to organs close to the uterus. This is more likely in women with multiple cesarean sections previously. Pain and infection may also result after an endometrial ablation.
The goal of an endometrial ablation is to reduce a woman’s bleeding, but not all patients will stop having periods altogether. Many patients report having light or normal periods following the procedure.