Ask the Doctor: Endometrial Ablation

March 03, 2020
Woman holding her stomach with pained expression

If you are suffering from excessive menstrual bleeding, breakthrough bleeding or have longer than average periods, endometrial ablation may be a solution. "This is the best procedure for someone who wants to avoid hormones or hysterectomy and takes less than 10 minutes," says OB/GYN Lawrence Koning, MD. Here, he shares important information about the process.

Q: What is endometrial ablation?

It’s a procedure that uses energy to remove/cauterize the lining of the uterus, known as the endometrium, which can lead to reduced or non-existent bleeding. It can be done in a doctor’s office or in a hospital, and there are several different techniques. The most common method is “radio frequency” energy to remove most of the lining of the uterus. Your doctor can recommend which one is best for you based on any health conditions you may have.

Q: Who is a candidate?

Women experiencing issues with their menstrual periods, such as heavy flow, longer periods, bleeding between periods or those who have become anemic from blood loss are good candidates. While hormone-based medications are typically the first line of treatment, they are not always successful and may have side effects. Endometrial ablation is also an option for patients who would prefer not to have a hysterectomy.

Q: What could prevent me from having this procedure?

It is not recommended for women who are post-menopausal, want to get pregnant in the future or have had a recent pregnancy, or have the following conditions: uterine or endometrium disorders; vaginal or cervical infection; pelvic inflammatory disease; cervical, endometrial, or uterine cancer; weakness of the uterine muscle wall; have an intrauterine device (IUD); past uterine fibroid surgery; classic or vertical C-section incision or abnormal structure or shape of the uterus.

Q: What should I expect after the procedure, and can I still become pregnant?

Common minor side effects include menstrual-like cramping for a few days, a discharge that can last for a few weeks and frequent urination for 24 hours. Pregnancy after ablation is rare, but can happen, and it increases the risk of miscarriage. It is recommended to either use birth control until after menopause or have a tubal ligation to prevent pregnancy and the complications that may arise from it. You also should still continue with routine screenings and pelvic exams.