When heavy menstrual bleeding becomes a problem, there are typically medications that are tried first. These include birth control pills, patches, or vaginal rings, or intrauterine devices that also deliver hormones. When these fail to produce results, or when a patient can’t use these solutions, endometrial ablation becomes an option.
Endometrial ablation isn’t recommended for postmenopausal women or those with uterine abnormalities, cancer of the uterus, increased risk factors for uterine cancer, or those with active pelvic infections. Pregnancy can occur after endometrial ablation. However, since the uterine walls are deliberately damaged during the procedure, any pregnancy would be high-risk. Miscarriage may result as an effect of the ablation, or the pregnancy may be ectopic, which means it’s outside the uterus, typically in the fallopian tubes or cervix.
The procedure may be performed in the office, depending on the method. Some methods require general anesthesia, and these are performed in a hospital. In most cases, the cervix must be widened to accept the ablation tool. This is done either with a series of rods, one after another, or using medication. Most ablation methods take 10 minutes or less and include:
Complications from the procedure don’t occur often, but there are a few things to watch for, such as infection or excessive bleeding. Depending on the ablation method, other organs in the area may experience heat or cold damage. The uterine wall may also risk puncture from surgical instruments.