Endometrial Ablation

If your periods are extremely heavy, your doctor may recommend endometrial ablation, which destroys the lining of the uterus that is normally shed during menstruation. There are multiple ways the procedure can be done, with various levels of invasiveness, depending on the condition and size of your uterus.
How successful is endometrial ablation?
Sometimes menstruation can be a problem, if too much blood is shed, which can lead to anemia (dangerously low levels of iron in the blood). Usually medications are used first to try and get menstrual bleeding under control, but if they are not successful, endometrial ablation may be recommended. This problem could also be fixed with a hysterectomy, but you may not want or not be able to easily have a hysterectomy.
If you wish to become pregnant in the future, you should not undergo endometrial ablation because the damage to the uterus will not allow you to carry a pregnancy to term. Endometrial ablation is also not appropriate if you have cancer of the uterus or are past menopause.
Your doctor will usually check for cancer before the procedure by sampling a small piece of tissue from your uterus, because if you have cancer, you will probably need a hysterectomy (surgical removal of the entire uterus) instead of endometrial ablation.
Your doctor will likely prescribe medication that will make the endometrium thinner, but this can also be accomplished via a D and C (dilation and curettage).
Your doctor will also discuss with you which procedure for endometrial ablation is right for you, and what type of anesthesia you will need.
Endometrial ablation can either be performed in the hospital or in your doctor's office, depending on the method. In all cases, your cervix will need to be dilated (opened up wide) in order for the doctor to reach your endometrium. Your doctor may give you medication for this, or insert a series of rods that gradually open the cervix.
For the endometrial ablation itself, there are many methods, including:
  • Heat - hot fluid, electrode, laser beam or microwaves are used to destroy the endometrium
  • Cold - freezing the endometrium destroys it
  • NovaSure - a mesh electrode placed in the uterus and transmitting radio frequency energy vaporizes the endometrial tissue in a few minutes (only one treatment should be necessary
When the endometrium heals from any of these procedures, the scarring results in reduced menstrual bleeding.
For the first few days after the procedure, you may have menstrual-like cramps and have to urinate more often. You will also have watery, bloody vaginal discharge which may last up to a few weeks. Ask your doctor how long you should wait before using a tampon or having sexual intercourse.
It may take a few months, but endometrial ablation usually results in lighter periods. You may even stop your periods completely. But remember that endometrial ablation is not a sterilization procedure, so you should continue to use birth control. You may be able to get pregnant after endometrial ablation, but a pregnancy could be hazardous and will likely end in miscarriage.
The younger you are when you undergo endometrial ablation, the more likely it is that your endometrium will regrow and you will have to repeat the procedure. 
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