How Does Endometrial Ablation Work?

Before treatment, the clinician checks the cause of bleeding and may examine the womb with imaging or a hysteroscope. Pregnancy must be excluded, because ablation is not a treatment during pregnancy and can make a future pregnancy unsafe.

During the procedure, a device passes through the vagina and cervix into the womb. It treats the endometrium while limiting treatment to the womb cavity. Different systems use different energy sources, and some procedures use sedation or anaesthesia. Periods may become lighter, irregular or stop, but the result varies and ablation does not remove the womb.

Tell the team about medicines, bleeding between periods, pelvic pain, previous procedures and any possibility of pregnancy. Arrange the recovery time recommended by your clinician and use only the pain relief advised for you. Watery or blood-stained discharge and cramping can occur after treatment; follow the clinic's instructions about bathing, sex, tampons and activity.

Discuss contraception before treatment. Ablation is not contraception, and pregnancy afterwards can be dangerous. Alternatives may include a hormonal coil or, in selected situations, hysterectomy. Adenomyosis and other causes of pain or bleeding may change which option is appropriate.

Contact your clinician urgently for heavy bleeding that does not settle, severe or increasing pelvic pain, fever, foul-smelling discharge, faintness, breathing difficulty or a positive pregnancy test after ablation. These symptoms need assessment for infection, bleeding or another complication.

Ask what is causing your bleeding, which ablation method is offered, whether your womb is suitable, what contraception is needed, how pain will be managed and which alternatives could address both bleeding and pelvic pain.