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Treatments > Endometrial Ablation

Endometrial Ablation

Endometrial ablation is a treatment that reduces the heaviness of periods by destroying the lining of the womb using heat (ablation).

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An instrument is inserted through the cervix into the womb, and once in place, delivers heat to the lining of the womb.

The consultant may recommend that the lining of the womb is thinned by giving you an injection about three to five weeks before the operation to give you the best possible result. Your consultant will discuss this with you and may arrange for it to be given in our outpatient clinic, or you can ask your GP to arrange the injection once a date for your operation is known. The injection may stop your period before the operation, or you may have irregular bleeding as well as temporary and reversible menopausal symptoms such as hot flushes and night sweats. These symptoms will last no longer than four to six weeks.

We will organise a routine blood test for you two to three days prior to your admission to ensure we have a blood match saved for you in case of an emergency. Without this we are unable to perform the procedure.

Success rate

After endometrial ablation, 40 to 60 in every 100 women have no periods at all. A further 30 to 40 in every 100 continue to have periods that are lighter than before, and around 10 in every 100 women have no change in their periods. The chance of needing another operation, either a repeat ablation or hysterectomy, is about 15 in every 100 cases.

Pregnancy

You should not have this procedure if there is any chance you would like to become pregnant in the future. If you do become pregnant, this treatment could increase the risk of complications. The operation itself is not a birth control method, so you will need to continue your contraception afterwards.

Alternative treatments for heavy periods

  • Hormonal therapy, including the combined contraceptive pill and progesterone pills can regulate and reduce periods.
  • Tranexamic acid, which is not a hormone, can reduce blood loss and is taken just on the heavy days of the period.
  • The Mirena® coil is a very popular treatment as it can reduce periods by 75% to 90%. This coil provides contraception and must only be changed every five years.

Risks

Most ablation operations are very straight forward, but on rare occasions, there can be complications. These include:

  • Bleeding. Sometimes there can be bleeding during the operation. If this happens, a small tube (catheter) is placed inside the womb for a few hours to stop it and the catheter is removed before you go home. You will be given fluids via a drip in the back of your hand to replace any blood loss.
  • Perforation. In as few as 1 in 100 patients, the telescope may go through the wall of the womb. If this happens, the operation is stopped, and you will be observed for any bleeding. Very rarely, we may have to carry out a bigger operation to close the hole through your abdomen which would mean a longer stay in hospital.
  • Fluid overload. Very rarely, the fluid used to fill the womb can get into your blood stream. If this happens the operation will be stopped, and medication given to remove the excess fluid. This involves a longer stay in hospital.
  • Infection. If you get lower abdominal pain and an offensive-smelling vaginal discharge after your operation, you may have an infection in the womb. This will definitely need treatment with antibiotics from your GP.

The operation

The operation is usually carried out under a general anaesthetic. The doctor will stretch open (dilate) the neck of the womb (cervix) and insert a telescope. The womb is then filled with fluid so the doctor has a clear view as they ablate the womb lining. The operation usually takes between 10 and 30 minutes.

Sometimes it will not be possible for the operation to go ahead due to technical reasons, or very rarely due to equipment failure, or the inability to position it correctly.

After the operation

A doctor will discuss your operation before you are discharged. You should be able to go home later the same day unless there have been complications or you have other health problems, in which case you may need to stay overnight.

You will need a responsible adult to collect you and be with you overnight. You must not drive after having a general anaesthetic.

Recovery

You may have some period-like pain for a few days. Simple pain relief such as paracetamol or ibuprofen should relieve this. Usually, you will bleed for a few days. During this time, it is best to use sanitary towels rather than tampons to reduce the risk of infection. As the womb heals you will continue to have a watery blood-stained discharge for 3 to 4 weeks.

You should rest for 24 hours

  • You can have a bath or shower the day after your operation
  • You can have sex again as soon as the discharge stops but you should use contraception as you did before the operation
  • You can continue with your normal activities 2 to 3 days after your operation

A follow-up hospital appointment is usually arranged for 6 months.

When should I seek medical advice?

While most women recover well after this procedure, complications can occur. You should call the Tetbury Hospital switchboard between 08:30 to 16:30, Monday to Friday on 01666 502336, or outside these hours seek medical advice from your GP or dial 111 if you experience:

  • Burning and stinging when you pass urine or pass urine frequently. This may be due to a urine infection which can be treated with a course of antibiotics.
  • Heavy or prolonged bleeding. If you feel unwell and have a temperature, this may be due to an infection in your uterus (womb). This can be treated with a course of antibiotics. Occasionally, you may need to be admitted to hospital where the antibiotics can be administered via a drip.
  • Pain in your lower abdomen. If you have pain across your lower abdomen, especially if you also have a temperature, this may be a sign of a more serious complication. Please dial 999 as you will need to be admitted to hospital.