What if endometrial ablation does not relieve heavy periods?

Ablation treats the womb lining, but bleeding can persist if some lining remains or if a condition such as fibroids, adenomyosis, a polyp or hormonal disturbance is contributing. Bleeding may also change over time. Pregnancy is uncommon after ablation but can be dangerous, so pregnancy must be considered if periods stop and bleeding or pain develops. Note how often you change protection, clots, fatigue, pain and bleeding between periods.

Book a review with the clinician who performed the procedure or a gynaecologist. Bring your bleeding record and medication list. Assessment may include a pregnancy test, blood tests for anaemia, examination or imaging. Options depend on the cause and your plans: medicines, treatment of a structural problem, another procedure or surgery may be discussed. Use contraception as advised because ablation is not a contraceptive treatment.

Get urgent medical care for rapidly increasing bleeding, faintness, shortness of breath, chest discomfort, severe or one-sided pelvic pain, fever, or a positive pregnancy test with pain or bleeding. Seek prompt advice if you feel unusually weak or the bleeding is interfering with daily activities. Anaemia and complications need treatment rather than prolonged self-management.

Could fibroids, adenomyosis, a polyp or retained lining explain this bleeding? Should I have a pregnancy test, blood count or scan? How can anaemia be checked or treated? Which contraception is suitable after ablation? What alternatives fit my symptoms and future plans?