Endometrial ablation is a procedure that destroys the endometrium, the tissue that lines the uterus. It’s performed to control excessively heavy bleeding, a condition called menorrhagia. Menorrhagia is more common among women in perimenopause, the time leading up to menopause when a woman’s periods stop completely. Sometimes, blood loss can be so excessive, it can interfere with normal daily living, and even interrupt sleep. Some people with menorrhagia also develop anemia as a result of their blood loss. Endometrial ablation uses state-of-the-art techniques to remove the endometrium to stop or reduce heavy bleeding. The procedure is performed in women who are through having children.
Prior to endometrial ablation, an in-depth exam will be performed to ensure a thick endometrium is the underlying cause of bleeding and rule out other possible causes. The treatment itself is performed on an outpatient basis, usually under sedation. Ablation used to be performed with curettage, a technique that uses a special instrument to scrape away the uterine lining. But today, there are many other methods for performing endometrial ablation, including:
Once the endometrium has been removed from the uterus, scar tissue will form that will help prevent the tissue layer from reforming. Most procedures take about 30 to 45 minutes to perform.
Nearly all patients experience significant reduction in menstrual flow following an endometrial ablation procedure, and about half of those treated will stop having periods entirely. In a few younger patients, heavy bleeding may reoccur, requiring a second treatment. Administering hormones for a few months prior to having an endometrial ablation procedure may help thin the uterine lining, making the procedure more effective in these younger patients.
Endometrial ablation is performed as a same-day surgery, so patients can return home shortly after their procedure is complete. There may be some cramping or minor vaginal bleeding or discharge for a 1 or 2 weeks, which should be controlled with pads and not tampons. Some women have an increased need to urinate during the first 24 hours after their procedure.
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