The lining of the uterus is called the endometrium; this tissue is expelled every month during menstruation. In women with excessively heavy bleeding, a procedure called endometrial ablation may be necessary to stop or control it. During the procedure, a thin layer of the endometrium is removed. No reproductive organs are removed, and no hormones are involved.
Function
If a woman has heavy menstrual bleeding, medication is typically the first mode of treatment, according to the American College of Obstetrics and Gynecology. If medication does not work, endometrial ablation may be performed in order to control the heavy bleeding. In some women, this procedure ceases menstruation, but in other women, the amount of bleeding is reduced. If endometrial ablation does not stop the heavy bleeding, other procedures might be needed.
Significance
According to the American Society for Reproductive Medicine, nearly 90 percent of women who undergo endometrial ablation have relief from heavy bleeding within a few months of the procedure. Younger women may need more than one ablation to have a complete response.
Types
Endometrial ablation may be done as an outpatient surgery or in a gynecologist's office. There are various ways of performing the procedure. Freezing involves inserting a probe into the uterus in which the tip of the tube freezes the uterine lining, guided by ultrasound. Another way of performing the procedure may involve microwave energy, in which the probe that is inserted into the uterus delivers microwave energy to the lining of the uterus, which destroys it. Radiofrequency involves using a probe that has a device on the tip that expands and applies radiofrequency energy to the uterine lining, which destroys the tissue; the lining is then removed by suction.
Side Effects
After the procedure, several side effects may occur. ACOG says these effects may include nausea, slight cramping for a few days and a watery vaginal discharge that may or may not be tinged with blood. This discharge may be heavy for a few days following the procedure but lightens up and may last several weeks. A woman also may urinate more than usual for 24 hours post-procedure.
Warning
Endometrial ablation is not for every woman with heavy bleeding. ACOG says that conditions in which this procedure is not recommended include disorders of the endometrium or uterus, uterine cancer, having been recently pregnant, or having a recent or current uterine infection. Endometrial hyperplasia, or excessive growth of the uterine lining, is also a contraindication for the procedure. Ablation lowers the chances of pregnancy and increases the risk of miscarriage, so ACOG advises that women who want to get pregnant should not have this done.
