Endometrial ablation destroys the uterine lining, or endometrium, in order to treat abnormal uterine bleeding, also known as heavy menstrual periods. The uterine lining is healed by creating scar tissue, which prevents heavy bleeding from occurring for the long term, or sometimes permanently. Methods of ablation include laser thermal ablation, heat treatment, electricity, freezing or microwave rays. Depending on the type of ablation method used, general anesthesia or local anesthesia may be used.
Who is a candidate?
In general, endometrial ablation is used to treat endometriosis (excessive inflamed uterine lining) and the resulting heavy menstrual periods that result from it in women who no longer want to have children, but do not wish to have a hysterectomy.
Who is not a candidate?
Candidates who have not yet exhausted other courses of treatment for their health conditions may want to consider other options before proceeding with endometrial ablation. For candidates who have not yet gone through menopause, whether they would like to have (more) children may be a consideration, or if they are comfortable with the onset of early menopause. Women with a higher risk of endometrial cancer are also not good candidates, as scarring can hide early warning signs of endometrial cancer, such as light spotting.
Prior to endometrial ablation, you will likely have several tests performed, including a pregnancy test, a check for cancer, and possible dilation and curettage (D&C) to thin the endometrial lining prior to the procedure. Review informed consent guidelines with your physician, including fertility outcomes after surgery. Your doctor will likely have you stop eating and drinking the night before the surgery.
The first few days after the procedure, typical side effects include cramps, watery vaginal discharge mixed with blood, and frequent urination. Pain from cramping can be relieved with over-the-counter pain medication, and the other side effects should subside with time. In the long run, menstrual periods should become lighter or disappear entirely. Refrain from heavy work or exercise for a few days. Most women are able to return to work and normal activity 2-5 days after the procedure. Wait until all discharge has stopped before resuming sexual intercourse.
As with any surgery, there are risks of complications related to infection or adverse reactions to anesthesia. Problems specific to endometrial ablation include accidental puncture of the uterus, burns to the uterus or bowel surface, and cervical laceration. Partial to complete loss of fertility is expected from endometrial ablation. If pregnancy does it occur, it can be hazardous and will likely not carry to term.
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