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Endometrial Ablation

What is Endometrial Ablation?

Endometrial ablation is an in-office or minimally invasive outpatient procedure that is performed to relieve heavy menstrual periods or menorrhagia. It involves destroying or permanently reducing or destroying the tissue that lines inside of the uterus that causes menstruation monthly (endometrial lining).  The procedure can be performed in several ways.

Radiofrequency Ablation – Novasure or Minerva Ablation

Ablation by freezing, Cryotherapy – HerOption

Surgical removal -Hysteroscopic resection

Destruction with heat Thermachoice ablation

Who is a good candidate for endometrial ablation?

An endometrial ablation is a great option for women who have completed childbearing or do not wish future pregnancy, who suffer from heavy menstrual periods due to hormonal imbalance or uterine fibroids.  Patients who have heavy bleeding because of thyroid dysfunction, endometrial hyperplasia or endometrial cancer are not candidates for endometrial ablation. Before having an endometrial ablation, pelvic ultrasound needs to be performed to access the uterus and ovaries.  Endometrial sampling (endometrial biopsy) needs to be done to rule out cancer or cancerous precursors.

Who is not a good candidate for endometrial ablation?

Women with postmenopausal bleeding

Women who desire future fertility

Women who have adenomyosis

How is the procedure performed?

On the day of the procedure, you will receive anesthesia  (medication for pain) which can be local, regional or general.  A speculum is placed in the vaginal canal to allow for the cervix to be visualized.  The cervix is cleaned and then gently dilated to allow the ablation instrument to reach the womb/uterus.  The device at the direction of your doctor will access the size of the uterus and confirm that the uterus is intact ( without perforation).  The procedure will then begin and is completed in minutes.

What can I expect post-op after endometrial ablation?

After the procedure, you may notice menstrual cramps and watery discharge.   Depending on how thick the endometrial lining is during the procedure, some patients notice small bits of grayish-brown tissue for 1-2 weeks.  Some patients will have an episode of heavy menses or bleeding about 4 weeks after the procedure. This should not cause alarm as it due to all the ablated tissue sloughing off after the procedure.  Once this is completed, most patients will notice very light bleeding or no bleeding at all afterward. If your menses stop, that does not mean you are in menopause, rather it means that the endometrial tissue has been successfully removed.