About the Procedure
About 20% of women will experience episodes of heavy menstrual bleeding during their childbearing years, and it is especially common as women approach menopause. For some women, heavy or prolonged bleeding during their period can lead to anemia, fatigue or a decreased quality of life.
Physicians may choose endometrial ablation as a treatment option if other treatments such as hormonal therapy do not provide relief and childbearing is completed.
Endometrial ablation provides an alternative to a hysterectomy and is generally a short, out-patient procedure. The recovery time is usually much shorter than that associated with a hysterectomy and patients may resume daily activities within a day or two.
Ablation removes a thin layer of the lining of the uterus which is the source of the bleeding. The procedure uses a lighted viewing instrument called a hysteroscope which has a small camera attached that allows the surgeon to see the inside of the uterus on a TV monitor during surgery. The hysteroscope is inserted through the vagina and the uterine lining is burned away or ablated.
There are different types of ablation techniques including electrocautery, laser beam, thermal, or freezing . Thermal or heated ablations may use radiofrequency or microwaves as the energy source or may use hot water to cauterize the endometrial lining. The procedure usually takes 15-45 minutes and recovery time in hospital is about 2 hours, depending on type of pain relief used.
As with all procedures there are risks which include problems with pain medication, blood loss or infection. More serious risks include an overload of fluid from the uterus into the bloodstream or a perforation of the uterus. However these are rare occurrences.
After the procedure, there are minor side effects which are common including menstrual-like cramping for 1-2 days, watery discharge mixed with blood, frequent urination for 24 hours and nausea. About 90% of women will have reduced menstrual flow after this procedure and up to 50% will stop having a menstrual period. Younger women are more likely to continue to have periods after an ablation.
Women should not become pregnant after an endometrial ablation. Ablation does not remove any of the reproductive organs, so routine Pap tests and pelvic exams are still needed. Women with large fibroid tumors, those with a high risk for endometrial cancer or women who plan become pregnant in the future are not candidates for endometrial ablation.