Endometrial ablation is a procedure to help decrease or stop heavy menstrual bleeding. It is a short procedure that is done in the operating room under an anesthetic. After it is completed you are able to go home and return to your usual activities within a day or two. At Brockville General Hospital, the device we use to complete this procedure is called Novasure. You can read more about it at www.novasure.com.
Endometrial ablation might be right for you if:
- You have heavy bleeding without a malignant cause
- You are finished having babies
- You want to avoid major surgery or you have factors that might make major surgery riskier for you
- You want to avoid using hormones to treat your bleeding
An endometrial ablation is not a form of birth control or sterilization, however you should not become pregnant after having an endometrial ablation. If you become pregnant after having an ablation, the placenta may not implant properly onto the ablated uterine lining and this can be dangerous for you and for a potential pregnancy. For this reason, you should be using some form of contraception after having an endometrial ablation. Some women elect to have a tubal ligation done at the time of their endometrial ablation.
An endometrial ablation is very effective at reducing menstrual bleeding. About 90% of women who have this procedure will have dramatically reduced bleeding, and about 40% will even stop having their period following this procedure. There are a small number of people where the procedure fails to decrease their bleeding enough to make it tolerable. For these women, other options can then be pursued.
There are risks with any procedure. For an endometrial ablation the cervix needs to be dilated open a small amount in order to insert the ablation device. It is possible to cause a perforation or hole in the uterus when dilating the cervix open. If this happens it is also possible to injure structures that are on the other side of the uterus (i.e the bowel and bladder). This happens rarely, less than 1 in 1000 procedures. Infection or bleeding can happen with any procedure but are also uncommon.
Over time, the lining of the uterus can heal somewhat and bleeding might resume after a number of years. For this reason, we normally like to reserve endometrial ablations for women who can reasonably expect to be in menopause within 5 to 10 years.