Endometrial Ablation: A Minimally Invasive Option for Heavy Periods
Learn how endometrial ablation can reduce heavy menstrual bleeding without major surgery.
In short: Endometrial ablation removes part of the lining of the uterus to reduce heavy periods. It suits women with heavy or long periods that do not respond to other treatment and who wish to avoid hysterectomy. It is done by heated balloon, radiofrequency, microwave, freezing or cautery. Periods may become much lighter or stop, but it is not suitable for women who want a future pregnancy, or with cancer of the uterus or active pelvic infection.
Endometrial ablation is a minimally invasive procedure that gently destroys the lining of the uterus (endometrium) to reduce heavy menstrual bleeding.
Depending on your body’s response, it might lead to one of the following:
- decreased menstrual flow
- some women stop having menstrual flow at all
The procedure doesn’t require abdominal incisions. It is usually offered when medical treatments (such as the hormonal coil or tablets) have not helped or are not suitable, and it can be an alternative to hysterectomy for women who have completed their families.
What are the indications of endometrial ablation?
- heavy or prolonged cycles that don’t respond to other treatments
- heavy cycles that affect your quality of life
- heavy cycles causing anemia
- bleeding between cycles is not itself a reason for ablation — it needs to be investigated first (examination, ultrasound, cervical screening and, if needed, hysteroscopy or biopsy)
Endometrial ablation is usually offered to women with a normal-sized uterus (no or only small fibroids) who have completed their families and would like an alternative to hysterectomy.
What are the methods of endometrial ablation?
- heated fluid balloon
- radiofrequency energy
- microwave energy
- ablation using very cold temperatures (cryoablation)
- burning using an electrical probe (electrosurgery)
Does endometrial ablation preserve fertility?
No — this procedure should only be considered by patients who don’t plan to have future pregnancies.
Pregnancy after ablation is very rare, and if it happens, it may carry a higher risk of complications such as a morbidly adherent placenta.
Because ablation is not a method of contraception, you will still need reliable contraception (or sterilisation) until menopause.
What should be excluded before endometrial ablation?
- Endometrial pathology — it should not be performed in cases of suspected or confirmed uterine cancer
- active pelvic infection
- certain uterine congenital anomalies
It also should not be performed after menopause, as it would offer little benefit at that stage.
What are the possible complications after the procedure?
- pain and cramping
- vaginal discharge
- infection
- bleeding
- uterine perforation
- fluid overload with certain methods
Can heavy bleeding return after ablation?
Yes, it’s possible for heavy bleeding to return over time, and further treatment may be needed in that case.
About 1 in 5 women eventually need further surgery or a hysterectomy, especially women who are younger when they have the procedure. Ablation can also make it harder to check the womb lining later, so any bleeding after menopause must still be reported to your doctor.
If you’re struggling with heavy or prolonged periods, Dr. Najeeb Layyous and his team can help you explore whether endometrial ablation or another treatment option is right for you.
Dr Najeeb Layyous F.R.C.O.G
Consultant Obstetrician, Gynecologist and Infertility Specialist
The best doctor and the best medical team in the Kingdom of Jordan, with kind treatment and care for the patient even after the visit. I advise anyone needing a gynaecologist and surgery to go to Dr. Najeeb’s clinic. Wishing you continued success.