Endometrial Ablation

What is endometrial ablation?

Endometrial ablation is a minimally invasive procedure designed to treat heavy or prolonged menstrual bleeding. It works by removing or destroying the lining of the uterus (endometrium), which is responsible for menstrual bleeding. This procedure is an effective alternative for women who haven’t found relief with medications or other non-surgical treatments.

The procedure is quick and typically performed as an outpatient treatment, allowing most patients to return home the same day. It can significantly improve quality of life by reducing or even stopping menstrual bleeding altogether.

When is endometrial ablation recommended?

Endometrial ablation may be recommended for women experiencing heavy or prolonged menstrual bleeding (menorrhagia) that affects their daily lives. It is particularly suitable if:

• Bleeding does not respond to medications or hormonal treatments.
• Long-term hormonal treatments are not suitable or desired.
• Heavy periods are causing complications such as anaemia or fatigue.
• Future pregnancies are not planned, as this procedure is not recommended for women who wish to conceive.

Your doctor will assess your symptoms, medical history, and treatment goals to determine if endometrial ablation is the right option for you.

Preparing for endometrial ablation

Proper preparation helps ensure a smooth procedure and recovery. Here’s what to expect:

• Initial consultation: Your doctor will review your medical history and perform tests such as a pelvic exam, ultrasound, or biopsy to rule out other conditions, such as fibroids or cancer.
• Pre-procedure instructions: You may be advised to avoid eating or drinking for a set period before the procedure. Your doctor may also ask you to stop taking certain medications, such as blood thinners, to reduce the risk of bleeding.
• Ask questions: Use this opportunity to discuss your concerns or expectations with your doctor to feel confident and informed about the procedure.

What happens during the procedure?

Endometrial ablation is usually performed under local anaesthesia, sedation, or general anaesthesia, depending on your needs. It typically takes 20 to 30 minutes and involves:

• Insertion of the device: A thin, flexible instrument is inserted into the uterus through the cervix, meaning no incisions are required.
• Ablation process: Different techniques may be used to remove or destroy the uterine lining, including:
• • Heat (thermal ablation)
  • Freezing (cryoablation)
  • Microwave energy
  • Radiofrequency energy
  • Hot fluid balloon therapy
• Completion: Once the procedure is complete, the device is removed, and you will be monitored briefly before being discharged.

Benefits of endometrial ablation

Endometrial ablation offers several advantages, including:

• Effective relief: Many women experience significantly lighter periods or no periods at all.
• Minimally invasive: No incisions are required, leading to less pain and faster recovery.
• Quick recovery: Most women can resume daily activities within a few days.
• Improved quality of life: Reduces or eliminates heavy bleeding, helping you feel more energised and less restricted in daily life.
• Non-hormonal option: Suitable for women who prefer to avoid long-term hormonal treatments.

Are there any risks or complications?

Endometrial ablation is generally safe, but like any medical procedure, there are potential risks. These may include:

• Infection or bleeding.
• Damage to nearby organs, such as the uterus or bowel (rare).
• Fluid overload during the procedure (extremely rare).
• Persistent or recurrent bleeding if the endometrial lining regrows.
• Rare complications if pregnancy occurs after the procedure.

Your doctor will explain these risks and provide guidance on how to minimise them both before and after the procedure.

Recovering from endometrial ablation

Recovery is usually quick, with most women resuming normal activities within a few days. Here’s what to expect:

• Post-procedure symptoms: You may experience mild cramping, discomfort, watery discharge, or light bleeding in the first few days. Pain relief and aftercare instructions will be provided.
• Rest and recovery: Rest is recommended for 24 to 48 hours. Strenuous activities and heavy lifting should be avoided for the first week.
• Follow-up care: A follow-up appointment will be scheduled to ensure your recovery is on track and to address any concerns.

Looking ahead: what can you expect?

Endometrial ablation can significantly reduce heavy menstrual bleeding or stop it entirely, improving quality of life for many women. However, it’s important to note:

• This procedure is not recommended for women planning future pregnancies, as pregnancy after ablation can lead to complications.
• Some women may require additional treatments if bleeding persists or recurs over time.

For most women, endometrial ablation is a highly effective solution, allowing them to return to daily activities without the burden of heavy periods.

If you’re struggling with heavy or prolonged menstrual bleeding and want to explore your options, speak with your doctor to find out if endometrial ablation is right for you. With the right care and guidance, this procedure can help you regain control and improve your overall well-being