Some women who experience heavy bleeding during their periods and don’t plan to have any or more children in the future decide to have endometrial ablation.

Endometrial ablation destroys a thin layer of the uterine lining (endometrium), which can help to reduce menstrual bleeding to normal or lighter levels. It can be helpful for women who experience heavy or long periods (longer than seven days), bleeding between periods or anemia as a result of heavy bleeding.

The procedure isn’t recommended for everyone, so ask your doctor if it’s right for you.

Endometrial ablation usually results in a significant decrease in your ability to get pregnant so you shouldn’t have the procedure if you’re planning to become pregnant. Additionally, ablation is not typically recommended for women who:

• Were recently pregnant
• Are past menopause
• Have pelvic inflammatory disease
• Have a vaginal or cervical infection
• Have a disorder of the uterus or endometrium
• Have cervical, uterine or endometrial cancer
• Are younger than age 40

In the past, women who suffered from heavy periods often had a hysterectomy (removal of the uterus).

An endometrial ablation is less invasive than a hysterectomy and can be performed on an outpatient basis.

Doctors today usually try to control heavy bleeding with medication or sometimes an intrauterine device (IUD) first. If medication isn’t effective, some common methods for endometrial ablation include:

• Radiofrequency – A probe sends radiofrequency energy into the uterine lining to destroy it.
• Freezing (cryoablation) – A thin probe is used to freeze the uterine lining.
• Heated fluid – Heated fluid flows freely throughout the uterus for about 10 minutes to destroy the lining.
• Heated balloon – A balloon is placed in the uterus, inflated and filled with heated fluid to destroy the lining.
• Microwave energy – A special probe applies microwave energy to destroy the uterine lining.
• Electrosurgery – A resectoscope and a heated instrument are used to destroy the uterine lining. This isn’t used as often as other methods.

After the procedure, some women experience increased urination for a day, nausea, bleeding and cramping for a few days, and watery-bloody discharge for a few weeks.

Here are some pros and cons of an endometrial ablation to discuss with your doctor:

Pros

• Periods should lighten or stop completely within a few months.
• Uterus and other pelvic organs remain intact.
• Minimally invasive, no incisions
• Often results in improved quality of life for most women

Cons

• Not recommended if you still want to have children
• Pregnancy after ablation, while rare, carries risk of miscarriage and complications.
• Bleeding may still occur after ablation, a hysterectomy may be needed in the future.
• The procedure carries risks (e.g., infection, bleeding, damage to uterine wall or bowel).

After an endometrial ablation, you’ll still need routine cervical cancer screening and pelvic exams. Doctors also recommend women continue using birth control until after menopause or undergo sterilization to prevent pregnancy after ablation.

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