Endometrial Ablation: What Is It, Side Effects & Recovery (2024)

What happens before endometrial ablation?

Your healthcare provider will make sure that endometrial ablation is the right procedure to reduce your bleeding. During this evaluation:

You’ll take a pregnancy test. You can’t be pregnant during an endometrial ablation.
Your provider may do a biopsy to look for abnormal cells in your uterus and make sure you don’t have cancer.
Your provider will check what medicines you’re taking. You’ll want to be sure that you’re not taking medicine that could cause problems during the procedure (for example, if you’re taking a blood thinner).
Your provider will order an MRI or ultrasound to take a closer look at your uterus.

You’ll prepare for the day of your endometrial ablation.

What happens during endometrial ablation?

An endometrial ablation may be done in the office or in the operating room. You’ll be given a gown and an IV. You’ll situate yourself on a table as if you’re having a pelvic exam. You may be given medicine about an hour before the endometrial ablation to help manage any discomfort after the procedure. Depending on the type of endometrial ablation, your provider may numb your pelvic area and give you sedatives so that you don’t feel any pain or discomfort during the procedure.

During endometrial ablation, your healthcare provider inserts a delicate, wand-like device into your vagin*. This device extends through your cervix and into your uterus, where it can reach the lining. Depending on the type of endometrial ablation, the device sends energy, heat or cold to destroy part of the lining. The technology makes things quick and you should have minimal or no discomfort during the procedure.

What are the types of endometrial ablation?

There are different types of endometrial ablation, but they all involve destroying the lining of your uterus.

Microwave: A small applicator releases microwaves that heat the lining of your uterus, destroying parts of it. The process takes from three to five minutes.
Radiowaves (radiofrequency): A wand-like instrument with a mesh tip unfurls inside your uterus, just enough so that radio waves can reach the lining. The mesh releases radio waves that heat and destroy parts of the lining. The process takes from one to two minutes.
Electricity (electrosurgery): A small, tube-like device with a viewing lens (resectoscope) is fitted with a wire loop, roller ball or laser that releases electricity. The electricity destroys parts of your uterus lining. The viewing lens helps your provider see inside your uterus and monitor the electrical currents as they turn parts of the lining into scar tissue. This type of ablation is the least common and may require you to have anesthesia. You’ll probably need to go to a hospital for electrosurgery.
Heated fluid (hydrothermal): A thin, flexible tube with a viewing lens that lets the doctor see inside your body (hysteroscope) moves room-temperature saline into your uterus. Once inside, the saline is heated to a temperature hot enough to destroy the lining. The process takes about 10 minutes. This kind of ablation works well for uteruses that have an irregular shape.
Heated balloon (balloon therapy): A tiny balloon is placed onto a thin tube (catheter). A fluid is pumped through the tube and into the balloon and heated. The heat causes the balloon to expand and touch the uterus lining. The heat from the balloon destroys those parts of the uterus lining that it touches. The process takes from two to 10 minutes.
Cold (cryoblation): A tube with a cold tip creates tiny ice balls that freeze parts of the uterus lining, destroying it. The process takes from 10 to 20 minutes.

What happens after endometrial ablation?

Have a friend or family member drive you home. Pay close attention to your body. You’ll probably notice some changes after you’ve had the endometrial ablation. They’re normal, so there’s no need to worry.

You may feel a little nauseous.
You may have to pee more the first day after the procedure.
You may have period-like cramps for one to three days after an endometrial ablation.
You may have light bleeding or pink discharge for a few weeks after. It’s usually heaviest on Day 2 and Day 3 after you’ve had the procedure. You’re bleeding the uterus lining that was destroyed so that you don’t have a heavy period later.

Give yourself time to heal. Don’t douche or use a tampon the first 3 days after you’ve had the procedure.