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Endometrial Ablation

What is Endometrial Ablation?

Endometrial ablation is an effective treatment for heavy periods (menorrhagia).

Some women bleed very heavily during their period. Heavy periods can affect many aspects of your life and increase your risk of developing anaemia, a condition where you don't have enough red blood cells to transport the oxygen around your body. This can make you feel tired, breathless and faint.

If you have heavy periods, one way of reducing the amount of blood you lose each month is to remove some of the lining tissue of your womb.

Preparing for endometrial ablation

Endometrial ablation is routinely done as a day-case procedure. This means you have the procedure and go home the same day. Depending on the type of ablation you have, you may have the operation done under either local or general anaesthesia. Local anaesthesia completely blocks feeling in the neck of the womb (cervix) and you stay awake during the procedure. General anaesthesia means you will be asleep during the operation. You may also be given medicines to make it easier to insert the instruments into your womb during the operation.

What happens during endometrial ablation 

Endometrial ablation usually takes about half an hour, including the time needed for anaesthesia and for waking up after the procedure.

There are a number of different types of endometrial ablation. For some of the techniques a thin camera called a hysteroscope is passed through your vagina and cervix so that your surgeon can see inside your womb.

What to expect afterwards 

If you have general anaesthesia, you will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off. You will need to wear a sanitary towel as you will have some vaginal bleeding. You will usually be able to go home when you feel ready. Your nurse may give you a date for a follow-up appointment. You will need to arrange for someone to drive you home. 

Recovering from endometrial ablation 

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. You should be able to get back to your usual day-to-day activities about a week after your operation. Follow your surgeon's advice about how long to wait before having sex.

You may have some vaginal bleeding for a few days and a watery discharge for a few weeks. If the discharge becomes smelly or changes in colour, or if you have pain and feel unwell, contact your doctor for advice because you may have an infection. You should use sanitary towels rather than tampons after having an endometrial ablation, to help lower your risk of infection. 

It can take a few months to see whether the operation has been successful. Most women have lighter periods after the procedure, some will stop having periods altogether. Contact your GP or surgeon if you start to have heavy periods again.

What risks or complications can occur? 

Endometrial ablation is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications.

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. You may have some cramping pains or discomfort, similar to period pains. You will also have some vaginal bleeding and discharge, which may last for a few weeks. If excessive, these symptoms may be a sign of infection of the womb.

Perforation of the womb and subsequent damage to your bowel is a rare complication. If perforation is suspected, your surgeon will perform a laparoscopy to assess the uterus and bowel. Further surgery may be needed to repair any damage found.

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