Endometrial Ablation

Endometrial ablation is a procedure that your OB/GYN may recommend as a treatment for menorrhagia. Menorrhagia is the medical term for menstrual bleeding that lasts more than 7 days. It can also be bleeding, which is very heavy. Untreated heavy or prolonged bleeding can significantly reduce the quality of your life and cause a host of uncomfortable symptoms, including anemia (iron deficiency).

During endometrial ablation, a thin inner lining of the uterus (also known as the endometrium) is removed. It is a minimally invasive gynecological procedure that can safely and effectively reduce or eliminate heavy menstrual bleeding. In some cases, menstrual bleeding may stop entirely for some time.

If medical management of your symptoms with oral medications is unsuccessful, endometrial ablation may be an option for you.

Generally, endometrial ablation is recommended for women who are finished with childbearing and want relief from heavy bleeding.

You would not be a candidate for endometrial ablation if you have any of the following conditions:

• If you were recently pregnant or want to become pregnant in the future
• If you are post-menopausal
• If you have uterine, cervical, or endometrial cancer
• If you have recently had a vaginal, cervical, or uterine infection
• If you are using an intrauterine device (IUD)
• If you have a weak uterine wall

Endometrial ablation is generally a short procedure that can be performed in your OB/GYN’s office. Only in cases where general anesthesia is required will you need to visit a hospital.

The procedure may be performed in one of the following ways, depending on the size and condition of your uterus:

• Heated Fluid. A hysteroscope is used to pump heated fluid into the uterus and circulate it for 10 minutes. The heat destroys the endometrium. This procedure works well for women with an irregular uterus shape due to intracavitary lesions or fibroids.
• Heated Balloon. A hysteroscope is used to insert a balloon into the uterus. The balloon is then filled with heated fluid till it expands enough to touch the uterine lining. The heat destroys the endometrium.
• Radiofrequency. An electrical mesh is inserted into the uterus. A strong radio wave is then passed to the expanded mesh through heat and energy, which destroys the endometrium.
• Microwave Energy. A wand-like tool is inserted in the uterus, and microwaves are passed through it. This destroys the uterine lining.
• Electrosurgery. A narrow scope is inserted into the uterus to view the uterine wall. A wire loop or rollerball connected to the end of the scope is heated and used to destroy the endometrium. Electrosurgery is not used very often and requires general anesthesia.
• Cryoablation. A probe with a freezing tip is inserted into the uterus to freeze and then remove the uterine lining.

Consult your doctor about your condition to find out what type of procedure may be suitable for you.

After the procedure, you may experience certain side effects, such as:

• Menstrual-cramp like symptoms for a couple of days
• A watery vaginal discharge mixed with blood for a few weeks
• A frequent urge to urinate immediately after the procedure
• Some nausea

These side effects are likely to be strongest in the 1 or 2 days immediately after the procedure, after which things tend to settle down.

While the side effects from endometrial ablation eventually subside, complications may arise after the procedure, which include:

• Bleeding and infection
• Injury due to the tools used during the procedure (this is very rare)

It is normal to experience some downtime after the procedure. Most women can return to their regular active lives in 1 or 2 days. The results of endometrial ablation may take a couple of months to manifest. While most women experience lighter menstrual bleeding after the procedure, others may stop having their cycles completely.

For some women, the results of endometrial ablation are not permanent. After a few years, their bodies might go back to having heavy or longer cycles once again. If this is the case for you, be sure to talk to your OB/GYN to find out your treatment options.

Endometrial ablation is not a sterilization procedure. Women should use contraception after the procedure because they can still become pregnant after the treatment. In such cases, the risks to the mother and the child are very high since the uterine lining has been removed.

If you are tired of dealing with the discomfort of heavy and prolonged menstrual cycles, call us in Newton at (617) 332-2345 or in Walpole at (508) 668-5555 to schedule an appointment. For your convenience, you may also request an appointment online.