Endometrial ablation is an outpatient procedure that can treat heavy menstrual bleeding. In this procedure, your OB-GYN uses a medical device called the Hydro ThermAblator (HTA) to circulate heated saline through your uterus to treat and destroy the endometrium. Following endometrial ablation, most women report substantially lighter periods, and many women no longer menstruate at all.
What conditions does endometrial ablation treat?
Endometrial ablation is usually performed as a treatment for menorrhagia, the clinical term for excessive menstrual bleeding. Women with menorrhagia experience heavy, clotting, or abnormally long menstrual periods. Menorrhagia typically presents as a symptom of another gynecological problem, such as:
- Infection. Uterine or cervical infections can cause excessive bleeding.
- Bleeding disorders. Conditions that keep the blood from clotting, such as hemophilia.
- Endometriosis. A common cause of heavy bleeding resulting from endometrial tissue developing outside the uterus.
- Uterine polyps or fibroids. Benign (non-cancerous) uterine growths can cause heavy bleeding.
- Hormonal imbalance. The hormones estrogen and progesterone are responsible for regulating your monthly cycle. Fluctuations in the balance of these hormones can cause problems, including heavy periods.
- Uterine cancer. In rare cases, heavy bleeding could be a symptom of uterine cancer.
Your gynecologist will be able to diagnose the cause of your menorrhagia. It’s important to note that endometrial ablation treats the symptom – it does not necessarily treat the underlying condition. Speak with your OB-GYN get a better understanding of your illness and the best course of treatment for you.
What is considered “excessive bleeding”?
Menorrhagia is a clinical condition that only your doctor can diagnose. Some experts estimate that menorrhagia affects up to 20% of women. Consider making an appointment for an evaluation if your periods are interfering with your everyday activities, or if you:
- Have periods that go on for more than 7 days.
- Find large clots in your menstrual blood.
- Experience fatigue during your period.
- Soak through two or more tampons or pads in an hour.
Can I get pregnant following endometrial ablation?
Endometrial ablation significantly reduces a woman’s ability to become pregnant. While it is not impossible to get pregnant following ablation, it is generally recommended that ablation only be performed for premenopausal women who are finished having children.
However, endometrial ablation is not a sterilization procedure. While the chances of getting pregnant are small, patients should use contraception or seek out sterilization after ablation. Pregnancy after an endometrial ablation could be very dangerous for both the woman and the fetus.
How does endometrial ablation HTA work?
During the procedure, your cervix will be slightly dilated, and two instruments will be inserted into your cervix: a hysteroscope and an HTA sheath. The hysteroscope is equipped with a lighted camera and will allow your doctor to view the inside of your uterus.
The sheath will allow room-temperature saline to flow into your uterus, filling the cavity and circulating through the HTA device. The HTA device will then begin to heat the saline to 194˚F. The hot saline heats the endometrium, blanching it and destroying it after about 10 minutes of treatment. Your doctor will then cool the saline to room temperature before draining it from your uterus and removing the sheath and hysteroscope.
What should I expect during my procedure?
Endometrial ablation HTA is typically performed as an outpatient procedure, right in your doctor’s office. At your appointment, you will be asked to undress from the waist down and lie down on the examination table with your feet propped up in stirrups. You and your doctor may decide what type of anesthesia to use:
- Local anesthesia – You will be awake during the procedure, but your pelvic area will be numbed. You may experience some mild cramping.
- Sedation – You will feel drowsy and numb, and may not remember the procedure.
- General anesthesia – You will be asleep during the procedure.
What are the risks of endometrial ablation HTA?
Like all medical procedures, endometrial ablation carries some risks. Please discuss your concerns with your doctor. Possible risks include:
- Perforation of the uterus
- Pulmonary edema or embolism
- Injury or burns to pelvic organs and tissue
- Post-ablation tubal sterilization syndrome – A painful complication that arises in some women who have undergone tubal ligation, followed by endometrial ablation.
Endometrial Ablation HTA Recovery
Following your procedure, you may experience some mild cramping, and possibly some nausea and vomiting. These symptoms should start to clear up after about a day. Most women are able to return to their normal routines the next day.
- You may experience some bloody discharge for several weeks after the procedure. Wear a pad to soak up the discharge.
- Avoid inserting anything into your vagina, including tampons, and refrain from vaginal sex for seven days after the procedure.
- If you experience abdominal pain, your pain worsens, or you develop a fever, call your doctor right away.
While your menstrual periods may continue to be heavy for the next few months, this should subside. Most women find that their periods become dramatically lighter and shorter as a result of the procedure, and some women’s periods disappear altogether. In a clinical trial, 98% of women reported that they were satisfied with their periods after receiving the treatment.