Endometrial Ablation

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KEY POINTS

• Endometrial ablation is a procedure for destroying or removing the inner lining of the uterus. This procedure may be done when you have bleeding from the uterus that is very heavy or has lasted a long time and other treatments have not helped.
• You will probably not be able to get pregnant after this procedure. However, if you do get pregnant, the risk of miscarriage and other problems is much higher.
• Ask your provider how long it will take to recover and how to take care of yourself at home.
• Make sure you know what symptoms or problems you should watch for and what to do if you have them.

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What is endometrial ablation?

Endometrial ablation is a procedure for destroying or removing the inner lining of the uterus. The uterus is the muscular organ at the top of the vagina. Babies grow in the uterus, and menstrual blood comes from the uterus. The lining of the uterus is called the endometrium.

You will probably not be able to get pregnant after this procedure. However, there is a chance you could get pregnant. If you do get pregnant, the risk of miscarriage and other problems is much higher. For this reason, talk with your healthcare provider about what kind of birth control is best for you.

When is it used?

This procedure may be done when you have bleeding from the uterus that is very heavy or has lasted a long time and other treatments have not helped. Destroying or removing the lining of the uterus may reduce or stop the bleeding. It does not change your hormone levels.

Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

Before you have the procedure, your healthcare provider may prescribe progesterone hormones or other medicine to stop your body from making estrogen for a while. This will shrink the lining of the uterus.

Your provider may put a small rod made of seaweed into the cervix the day before the procedure. The cervix is the opening to the uterus. The rod will help soften and dilate the cervix. It can make the procedure easier and safer to perform.

• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help you with your day-to-day tasks.
• Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It’s best to quit 6 to 8 weeks before surgery.
• Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

The procedure may be done in your provider’s office, at a hospital, or in a surgery center.

You will be given a local, regional, or general anesthetic to keep you from feeling pain. A local or regional anesthetic numbs part of your body while you remain awake. Before the procedure you will be given medicine to help you relax, but you may be awake during the procedure. General anesthesia relaxes your muscles and puts you into a deep sleep.

Your healthcare provider will use a tool to stretch open (dilate) your cervix. Your provider will then guide a lighted tube with a camera and a tool into your vagina, through the cervix, and into your uterus.

Your provider may remove tissue from the lining of the uterus to send to the lab for tests.

The lining of the uterus may be destroyed in different ways, such as:

• A probe that freezes the lining
• A probe that sends energy into the lining and then uses suction to remove it
• Heated fluid put into the uterus with a scope
• A probe that uses microwave energy to destroy the lining
• An electrical tool, like an electrical wire loop

It usually takes only a few minutes to do the ablation.

What happens after the procedure?

Usually you can go home the same day.

Many women don’t have any menstrual bleeding after ablation. Some keep having periods but with just normal or light bleeding.

Follow your healthcare provider's instructions. Ask your provider:

• How and when you will get your test results (if your provider removed tissue for tests)
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You may have problems with anesthesia.
• You may have infection or bleeding.
• Other parts of your body may be injured during the procedure.
• If you get pregnant, you are more likely to have a miscarriage or other problems.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.