Endometrial Ablation Surgery: A Treatment Option for Heavy Periods

What Is Endometrial Ablation Surgery?

The inside of the uterus is lined with tissue called the endometrium. Every month during your cycle, this lining builds up to prepare for a potential pregnancy. If you don’t become pregnant, your body sheds this lining. This shedding is what you know as your period.

Endometrial ablation is a medical procedure that destroys this lining. If the lining is removed or destroyed, there’s nothing – or very little – for the body to shed each month. The procedure isn’t designed to remove the uterus itself. This is a key difference between ablation and other surgeries. Because the uterus stays in place, your hormones aren’t affected in the same way they might be with other surgeries. The primary outcome of menstrual reduction surgery is a lighter or non-existent flow.

Who’s a Candidate for Endometrial Ablation Surgery?

Our consultants at Sussex Premier Health will look at your medical history and lifestyle before recommending endometrial ablation surgery. Doctors generally advise against it if you’ve gone through menopause or if you have certain abnormalities in the shape of your uterus, but you may be a good candidate if:

• You Have Unusually Heavy Periods – You soak through a pad or tampon every hour, or your bleeding lasts longer than seven days.
• Medication Hasn’t Worked – You’ve tried pills or IUDs to control the bleeding, but they haven’t solved the problem.
• You’re Done Having Children – Endometrial ablation makes it very difficult to get pregnant, and if you do get pregnant, it can be extremely dangerous for you and the baby.
• You Don’t Have Cancer – This procedure is not a treatment for uterine cancer.

Preparing for the Procedure

Before your endometrial ablation surgery, you’ll have a few appointments with your gynaecologist. They need to ensure your heavy bleeding isn’t caused by something else – like fibroids or polyps – which might need a different treatment. In addition to following instructions related to eating and drinking before the surgery, preparation usually involves:

• Biopsy – A doctor may take a tiny sample of your uterine lining to test for cancer cells.
• Imaging – An ultrasound may be used to examine the shape and size of your uterus.
• Medication – In the weeks leading up to surgery, your doctor might prescribe medication to thin the lining of your uterus. These procedures are often more successful when the lining is thin.

How Endometrial Ablation Works

Among the best things about this heavy period treatment is that it’s usually done as a day case, meaning you won’t have to stay in hospital overnight. The actual ablation part typically lasts less than 10 minutes, although preparation and recovery time in the clinic will take longer.

There’s typically no cutting involved. Your doctor will insert narrow tools through the vagina and cervix to reach the uterus. Then, they’ll use one of the following methods – depending on what’s best for your circumstances – to destroy your uterine lining:

• Radiofrequency – A probe sends radiofrequency energy into the lining to vaporise the tissue.
• Freezing (Cryoablation) – A small probe creates very cold temperatures to freeze and destroy the lining.
• Heated Fluid – Saline fluid is put into the uterus and heated. This is great for women who might have an irregularly shaped uterus.
• Balloon Therapy – A balloon device is placed in the uterus and filled with heated fluid.
• Microwave Energy – A special wand applies microwave energy to the endometrial lining.

Potential Risks During Endometrial Ablation Surgery

Every surgery has risks, even minimally invasive ones. While complications are rare, they may include:

• Perforation – This is when the surgical tool accidentally pokes a hole in the wall of the uterus.
• Damage to Nearby Organs – Rarely, the heat or cold used can damage the bowel or bladder.
• Infection – As with any procedure, there’s a small risk of infection afterwards.
• Pain or Cramping – This is a common symptom immediately after the procedure, but it usually subsides quickly.

Because pregnancy is dangerous after ablation, you’ll still need to use birth control or consider sterilisation if you haven’t already.

Recovering From Surgery

Endometrial ablation recovery is generally faster than that of other surgeries. Because there are no large incisions to heal, most women go home the same day and return to their normal routines within a few days. However, you’ll be advised to avoid using tampons or having sex for a short period to allow the uterus to heal properly. Here’s what you can expect during recovery:

• Cramps – You might feel menstrual-like cramps for a few days. Over-the-counter painkillers usually help.
• Discharge – It’s very common to have a watery or bloody discharge mixed with the shed tissue. This can last for a few weeks.
• Fatigue – You might feel tired for a day or two as the anaesthesia wears off.

The Benefits of Endometrial Ablation

The primary benefit of endometrial ablation is a reduction in bleeding. For many women, periods stop completely. For others, they become much lighter, which is a huge relief. Other key benefits are:

• Alternative to Hysterectomy – A hysterectomy involves removing the entire uterus. It’s a major surgery with a long recovery time. Ablation offers a solution for heavy periods without the risks and downtime of major organ removal.
• Quick Recovery – You can get back to your life almost immediately.
• No Visible Scars – Since the tools go through natural openings, there are no cuts on your stomach.
• Improved Quality of Life – Without the fatigue and stress of heavy bleeding, you’ll likely have more energy and freedom to do the things you love.