January 10, 2020
Endometrial ablation is an effective surgical procedure performed to reduce abnormal uterine bleeding while sparing the uterus. Endometrial ablation is an outpatient procedure associated with rapid recovery, minimal complications, and high patient satisfaction rates.
Abnormal uterine bleeding (AUB) affects about 30% of all adult women. AUB sufferers have bleeding between menstrual periods, heavy menstruation that lasts longer than average or irregular intervals between periods. Many women will seek medical treatment for this inconvenient to unbearable condition. When other medical treatments, such as hormonal medication and therapeutic options are ineffective, endometrial ablation may be recommended.
Why endometrial ablation?
Doctors recommend endometrial ablation to women who have exhausted nonsurgical treatments and are done having children. This procedure aims to curb menstrual bleeding to normal levels or less by destroying the endometrium—the lining of the uterus responsible for heavy periods. After an endometrial ablation, about 9 out of 10 women find they have a lighter period or no period at all.
Endometrial ablation has fewer complications than other procedures. Conducted in-office, the procedure does not require hospitalization and is more comfortable for patients. Additional advantages include:
- Most women return to normal activities in a day or two.
- No surgical incisions as the small instruments are inserted through the cervix
- A decreased risk of surgical trauma
- Fewer risks of postoperative complications
- Limited need for general anesthesia
- Direct cost savings to insurance companies
- Less indirect costs as patients can return to work sooner
- Results can last until menopause avoiding the need for continued, daily medication
The procedure often produces normal symptoms that can last for a few days or several weeks. Symptoms often abate with recommended over-the-counter pain relievers and rest. Symptoms to expect after the procedure include:
- Vaginal bleeding can occur for a few days. Bringing a sanitary pad is recommended.
- Strong cramping, similar to menstrual-like cramps, is expected for the first few days.
- The need to urinate more often is common for several days.
- There may be a watery-bloody discharge for several weeks.
It’s important to follow some basic rules after the procedure to minimize adverse effects:
- Have someone available to drive after the procedure.
- Do not use douche, tampons, or have sex for 2 to 3 days or as advised by your doctor.
- Avoid strenuous activity or heavy lifting.
- Take a recommended pain reliever. Avoid aspirin and some other pain medicines that may increase the chance of bleeding. Check with your doctor for recommendations.
Most patients find themselves healing from endometrial ablation very quickly. Many return to a normal diet and activity within a few days.
Inform your healthcare provider right away should any of the following symptoms develop as they may be indicators of serious complications.
- Foul-smelling drainage from the vagina
- Fever or chills
- Severe abdominal pain
- Heavy bleeding lasting longer than 2 day after the procedure
- Trouble urinating
Although these complications are rare, it is good to discuss any concerns about risks before the operation.
After endometrial ablation
Since endometrial ablation only removes the lining of the uterus and not the entire uterus, birth control is still recommended. While conception is unlikely, pregnancy can still happen and most likely will result in miscarriage. Appropriate birth control options can help prevent pregnancy and its potential complications. And, if you’ve already gone through menopause, you should consult with your doctor about hormone therapy.
Abnormal uterine bleeding can interfere with a woman’s everyday life—preventing certain activities, being intimate or even dictating clothing choices. If you have heavier than normal periods, bleeding between periods or periods that last five days or more, talk to your doctor. You may benefit from this minimally invasive, in-office procedure.
Endometrial ablation may be the answer to stopping the menstrual intrusion taking over your life.