How Long Does Endometrial Ablation Last?

Endometrial ablation is done to reduce excessive menstrual bleeding that has not subsided with medications.

The expected effect of endometrial ablation usually shows up in a few months and usually lasts for a longer time in most women.

About 3 in 10 women will see a significant reduction in their menstrual bleeding.

Nearly 50% of women who undergo this treatment will have their menstrual periods stopped permanently.

This procedure is recommended for those women who no longer plan to have a baby. You can still become pregnant after endometrial ablation because all other reproductive organs are still intact. However, if you get pregnant, the risk of miscarriage or the fetus being implanted in the fallopian tube (ectopic pregnancy) is extremely high. Such a pregnancy can be fatal for the mother. Hence, it is recommended to either use contraceptives or plan for a sterilization surgery after the procedure.

Your doctor will recommend other options for you if you are planning to have your baby in the future (like surrogacy).

Endometrial ablation removes the entire thin layer of the endometrium by heating or freezing it. It can be performed either in a doctor’s office as an outpatient or in the operative room during a hospital stay.

The surgeon can perform endometrial ablation using any of the following methods:

• Cryoablation: It is freezing the endometrium with the help of liquid nitrogen.
• Radiofrequency ablation: It is the use of radiofrequency waves to vaporize the endometrium.
• Hot fluid: It is circulating heated saline fluid within the uterus.
• Heated balloon: It is the insertion of a balloon device into the uterus and inflating it with hot liquid.
• Microwave energy: It is the use of a slender wand to emit microwaves that heat the endometrium.
• Electrosurgery: It is the use of electric current passed through wires to burn the endometrium (requires general anesthesia to make you sleep throughout the procedure).

Your surgeon will discuss with you all the benefits and risks of the procedure. Usually, you will be asked 

• If you are pregnant or think you may be pregnant.
• If you have an intrauterine device (IUD) fitted inside the uterus.
• If you are allergic to any medicines.
• About all medicines that you are on.
• If you are particularly taking any blood-thinning medications (such as aspirin, heparin, and warfarin). This will be discontinued for a few days before and after the surgery.
• To take some medicines several weeks before the procedure. These medicines will make the endometrium thin enough to get ready for the surgery.
• To stop eating and drinking (fast) after midnight (generally in case of general anesthesia).

Make sure that you follow all these and any other instructions given by your doctor. You can also make a list of all doubts you have before the surgery and get it cleared by your doctor.

After endometrial ablation, you might experience

• Frequent urination: You may feel like peeing more than usual in the first 24 hours of the surgery. 
• Abdominal cramps: These are usually similar to the cramps that you typically experience during your periods. They usually last for a few hours to a few days and can be relieved by over-the-counter pain medications.
• Minimal vaginal bleeding and vaginal discharge: Most bleeding subsides within a few days followed by a clear, watery discharge, that stays up to two weeks.
• Nausea.

Being a minor procedure, recovery takes a few days to a week. It might take two weeks in some patients. You might be able to resume all your activities immediately after the surgery. Strenuous activities can wait for a week. Make sure to ask your doctor how long the recovery period will be for you.

Endometrial ablation carries relatively fewer risks than major surgical procedures such as a hysterectomy. Although minimal, the possible complications are as follows:

• Infection
• Internal bleeding’
• Injury to the uterus and surrounding organs (such as the ureter)
• Damage to the vagina, vulva, or bowels from excess cold or heat
• Fluid overload (due to absorption of liquid in the blood vessels)