Endometrial Ablation FAQs

The endometrium—the lining of your uterus—provides a place for a fertilized egg to implant within the womb. Your endometrium does this by thickening with blood during a process called the menstrual cycle. Menstruation occurs when the endometrium sheds the excess blood that is no longer needed, and the cycle begins again.

Some conditions can cause abnormally heavy menstrual bleeding, which may increase to such an unmanageable level that it requires a surgical procedure to correct. Endometrial ablation is available as an alternative to a hysterectomy. Rather than removing your uterus entirely, an endometrial ablation destroys the interior lining of your uterus. In many cases, this will put a stop to your periods entirely. If not, it will probably lighten your monthly flow to a normal level.

When You Need One

If your menstrual bleeding is so heavy that it interferes with your normal activities, your doctor may recommend an endometrial ablation to either stop the bleeding entirely or get it under control. Endometrial ablation might be right for you if:

You are anemic (from blood loss)
Bleeding persists for more than eight days
Excessive menstrual bleeding causes you to change tampons or pads every two hours or less

However, not every woman can benefit from endometrial ablation. For example, women who have an active uterine infection, uterine cancer or an increased risk for it, as well as postmenopausal women, should not receive endometrial ablation. If you are pregnant at the intended time of the procedure, the endometrial ablation cannot continue.

While endometrial ablation is not a sterilization procedure, women who intend to have more children should not undergo it. Endometrial ablation makes it more difficult to conceive, and any pregnancies that do result after the procedure are likely to involve high risk to mother and child. Endometrial ablation also increases the risk of an ectopic pregnancy, a nonviable pregnancy in which the fertilized egg implants outside of the uterus.

Endometriosis is a condition in which tissue from the uterine lining starts growing outside of the womb for unknown reasons. Although endometriosis can cause abnormally heavy bleeding, your doctor may not recommend an endometrial ablation as the first treatment option to address it.

The Process

Depending on the method used, the procedure can take place in either your doctor’s office or an operating room. Instead of making an incision,, your doctor will dilate your cervix to allow him or her to insert the necessary ablation tools into your uterus and perform the ablation.

Ablation with heated fluids is common. It may involve inserting a balloon inside your womb, filling it with heated fluid and allowing it to explode, or your doctor may pump heated saline directly into your uterus. Your doctor may also perform the ablation using one of several other different methods:

High-energy radio frequencies
Microwave energy
Electrosurgery
Extreme cold (cryoablation)

Each of these techniques is different, but the end result is the same. The lining of the uterus is delicate and cannot withstand extreme heat, extreme cold, bombardment with microwaves, etc.

Although complications are rare, there are risks involved with endometrial ablation. You should discuss any concerns you have, before and after your procedure, with your doctor.