My Doctor has Recommended an Endometrial Ablation; What do I Need to Know?
Dr. Kate Dudek • October 2, 2022 • 5 min read
Ablation of the endometrium is a gynaecological procedure that has been in use since the late 19th century. The aim of the procedure is to control vaginal bleeding without the need for a hysterectomy. It works by destroying (ablating) the lining of the uterus (endometrium).
When will an endometrial ablation be recommended?
Endometrial ablations are generally recommended to those women who experience prolonged bouts of heavy menstrual bleeding. They are rarely the first approach as most doctors will be keen to reduce blood loss using medications or an intrauterine device (IUD) first.
Your doctor might recommend an endometrial ablation if your:
- Periods are so heavy that your pad or tampon needs changing every two hours.
- Blood loss is putting you at risk of becoming anaemic.
- Periods regularly last for longer than eight days (defined as abnormal uterine bleeding).
Whilst not used for sterilisation, most women who undergo the procedure end up infertile, so you should not have an endometrial ablation if you intend to have children in the future. Pregnancies that follow endometrial ablations are very high risk and can be ectopic or end in miscarriage.
How is an endometrial ablation performed?
Once you and your doctor have decided that an endometrial ablation is the best option for you, he or she will first of all want to rule out any possibility of pregnancy. Assuming a pregnancy test comes back negative, your doctor will prepare you for the procedure. Sometimes medications are given or a dilation and curettage (D&C) is performed to thin the endometrium, prior to the ablation.
Advances in modern medicine have meant that many endometrial ablations carried out today can be performed as outpatient procedures and you will be able to go home the same day. Unlike some of the more invasive gynaecological techniques, a uterine ablation does not require any incisions to be made to the abdomen. Instead, the required tools are passed through the vagina and cervix to reach the uterus.
The first stage is to gently widen (dilate) the cervix using a series of rods to increase the diameter. This will give your doctor the room to maneuver whichever instruments he/she is using. A hysteroscope will usually be inserted to enable the doctor to see the inside of the uterus and sometimes carbon dioxide gas will be used to expand the uterus for the duration of the procedure.
The exact method used will depend on the size and condition of your uterus, as well as resource availability.
Types of endometrial ablation
- Electrosurgery (electrocautery): A wire loop is heated with an electric current and passed into the uterus. Once there, it carves furrows into the endometrium. Requires general anaesthetic.
- Cryoablation: Extreme cold is used to create ice balls that destroy the lining of the uterus. Each freeze cycle lasts about 6 minutes and the number of cycles required will depend on the size and shape of the uterus. Real-time ultrasound is used to track the state of the endometrium throughout.
- Free-flowing hot fluid: Saline solution, heated to between 80 and 90°C is circulated within the uterus for about 10 minutes. This is ideal for women who have an irregular shaped uterus, or one distorted by abnormal tissue growth, for example, fibroids.
- Heated balloon: A balloon device is inserted through the cervix and inflated once in the uterus, using fluid heated to 87°C. The procedure takes between two and ten minutes, depending on the condition and size of the uterus.
- Microwave: A slender tool is inserted through the cervix. Once in place, it emits microwaves to heat and destroy the endometrial tissue. The usual duration for this procedure is 3-5 minutes.
- Radiofrequency: A flexible, mesh device is inserted into the uterus, where it transmits radiofrequency energy that vaporises the endometrial tissue within a couple of minutes.
Some doctors will advocate a partial endometrial ablation, whereby only part of the endometrial wall is destroyed. This is with a view to reducing the number of late-onset complications seen with total ablations. Up to a quarter of women who have an endometrial ablation will end up needing a hysterectomy and this is particularly true for younger women. Preliminary data suggests that partial ablations have no long-term complications and result in improved quality of life scores and fewer hysterectomies. However, larger studies are required to validate this finding.
Do endometrial ablations work?
Approximately 80% of women see a reduction in menstrual blood loss following endometrial ablation. Documented risks, such as damage to nearby organs and puncturing of the uterine wall occur very rarely and few women report procedure-related complications. Side effects are minimal; cramps, which can last a few days, and a watery, bloody vaginal discharge and increased need to pass urine, which usually passes within 24 hours.
Overall, the procedure is considered safe, effective and minimally invasive. It has reduced hysterectomy rates and improved the quality of life for many women trapped in a cycle of relentless heavy periods.
Try Nabta’s post-surgery pack after the procedure.
Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and menopause.
Get in touch if you have any questions about this article or any aspect of women’s health. We’re here for you.
Sources:
- “Endometrial Ablation.” Johns Hopkins Medicine, www.hopkinsmedicine.org/health/treatment-tests-and-therapies/endometrial-ablation.
- “Endometrial Ablation.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Sept. 2018, www.mayoclinic.org/tests-procedures/endometrial-ablation/about/pac-20393932.
- Laberge, Philippe, et al. “Endometrial Ablation in the Management of Abnormal Uterine Bleeding.” Journal of Obstetrics and Gynaecology Canada, vol. 37, no. 4, 1 Apr. 2015, pp. 362–376., doi:10.1016/s1701-2163(15)30288-7.
- Mccausland, Vance, et al. “Partial Endometrial Ablation: A 10–20-Year Follow-Up of Impact on Bleeding, Pain, and Quality of Life.” Journal of Gynecologic Surgery, vol. 32, no. 4, 22 July 2016, pp. 230–235., doi:10.1089/gyn.2016.0012.
- Wortman, Morris. “Late-Onset Endometrial Ablation Failure.” Case Reports in Women’s Health, vol. 15, July 2017, pp. 11–28., doi:10.1016/j.crwh.2017.07.001.
Download the Nabta App
Related Articles
7 Healthy Eating Tips for Postpartum Weight Loss In 2024
Your new baby has arrived, and you are eager to get back into shape. However, [losing weight after pregnancy](https://nabtahealth.com/articles/7-healthy-eating-tips-for-postpartum-weight-loss/) takes time and patience, especially because your body is still undergoing many hormonal and metabolic changes. Most women will lose half their baby weight by 6-weeks postpartum and return to their pre-pregnancy weight by 6 months after delivery. For long-term results, keep the following tips in mind. Prior to beginning any diet or exercise, [please consult with your physician](https://nabtahealth.okadoc.com/). 1\. **Dieting too soon is unhealthy.** Dieting too soon can delay your recovery time and make you more tired. Your body needs time to heal from labor and delivery. Try not to be so hard on yourself during the first 6 weeks postpartum. 2\. **Be realistic**. Set realistic and attainable goals. It is healthy to lose 1-2 pounds per week. Don’t go on a strict, restrictive diet. Women need a minimum of 1,200 calories a day to remain healthy, and most women need more than that — between 1,500 and 2,200 calories a day — to keep up their energy and prevent mood swings. And if you’re nursing, you need a bare minimum of 1,800 calories a day to nourish both yourself and your baby. 3\. **Move it**. There are many benefits to exercise. Exercise can promote weight loss when combined with a reduced calorie diet. Physical activity can also restore your muscle strength and tone. Exercise can condition your abdominal muscles, improve your mood, and help prevent and promote recovery from postpartum depression. 4\. **Breastfeed**. In addition to the many benefits of breastfeeding for your baby, it will also help you lose weight faster. Women who gain a reasonable amount of weight and breastfeed exclusively are more likely to lose all weight six months after giving birth. Experts also estimate that women who breastfeed retain 2 kilograms (4.4 pounds) less than women who don’t breastfeed at six months after giving birth. 5\. **Hydrate**. Drink 8 or 9 cups of liquids a day. Drinking water helps your body flush out toxins as you are losing weight. Limit drinks like sodas, juices, and other fluids with sugar and calories. They can add up and keep you from losing weight. 6. **Don’t skip meals**. Don’t skip meals in an attempt to lose weight. It won’t help, because you’ll be more likely to binge at other meals. Skipping meals will also make you feel tired and grouchy. With a new baby, it can be difficult to find time to eat. Rather than fitting in three big meals, focus on eating five to six small meals a day with healthy snacks in between. 7\. **Eat the rainbow.** Stock up on your whole grains, fruits, and vegetables. Consuming more fruits and vegetables along with whole grains and lean meats, nuts, and beans is a safe and healthy diet. ose weight after postpartum Is one of the biggest challenge women face worldwidely. Different Expertise and studies indicated that female might lose approximately 13 pounds’ weight which is around 6 KG in the first week after giving birth. The essential point here is that dieting not required for losing the weight, diet often reduce the amount of some important vitamins, minerals and nutrients. **Here are seven tips from the professional nutritionist perspective that can be considered for losing weight after postpartum these are;** 2\. Considered food like fish, chicken, nuts, and beans are excellent sources of protein and nutrients. 3\. A healthy serving of fat, such as avocado, chia seeds or olive oil 4\. With the balance diet please consider to drink plenty of water to stay hydrated. 5\. Regular exercise helps to shed extra pounds and improve overall health. 6\. Fiber-rich foods should be included to promote digestive health and support weight loss efforts. 7\. Don’t forget about self-care. By making these dietary changes and incorporating physical activity, you can achieve postpartum weight loss sustainably and healthily. **Sources:** * Center for Disease and Control and Prevention * Healthy Weight: it’s not dieting, it’s a lifestyle. Obstetrics and Gynecology * The risks of not breastfeeding for mothers and infants. The American College of Obstetrics and Gynecologists * Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Powered by Bundoo®
Is it Safe for Toddlers and Children to eat raw Oysters?
Food-borne illnesses do not discriminate — anyone can become sick. Raw oysters have earned a reputation as a potentially dangerous food. Also, some groups of people have a [greater risk of serious illness](https://nabtahealth.com/articles/is-fish-oil-safe-for-children/) than others, including children. Eating raw oysters comes with the risk of being exposed to Vibrio vulnificus, a potentially life-threatening bacteria. Young children, those under 5 years of age, are more susceptible to food-borne illness because their immunity isn’t fully developed. Here are some facts you should know before you give your young child raw oysters: ##### What will happen if my child eats a contaminated oyster? In reality, allowing your [child to eat](https://nabtahealth.com/articles/is-it-safe-for-toddlers-and-children-to-eat-raw-oysters/) raw oysters might have zero consequences, no matter how many he or she eats. Unlike other bacteria, V. vulnificus cannot be smelled, seen, or tasted. There is no way to determine if the raw oyster is safe to eat. V. vulnificus cannot be killed by a lot of hot sauce, nor are you guaranteed safety by letting your child just try one or two oysters. If your [child eats a raw oyster](https://nabtahealth.com/articles/is-it-safe-for-toddlers-and-children-to-eat-raw-oysters/) that is contaminated with V. vulnificus, it is important to be familiar with the signs and symptoms of food poisoning. In generally healthy people, V. vulnificus can cause vomiting, diarrhea, and abdominal pain. In some cases, it can become worse and infect the blood (invasive septicemia) resulting in fever, chills, and septic shock. V. vulnificus is a serious cause for concern because about half of people who contract the blood infection die. If you are suspicious of food poisoning and/or your child has symptoms, get in touch with your healthcare provider, or even head to the ER. ##### What should I do? To be safe, you may want to hold off on feeding your child raw oysters for a few years, or at least until he or she is five years of age. If oysters are a staple in your household, or a special treat here and there, make sure to thoroughly cook a few for your little one to try. Cooking (prolonged exposure to high heat) is the only way to kill the bacteria and make sure you and your family will be safe. Get yourself a [coach](https://nabtahealth.com/product/conscious-motherhood-coaching-session/) and learn more. **Sources:** * Food & Drug Administration * Raw Oyster Myths. Powered by Bundoo®
A Beginner’s Guide to Menstrual Cups: A Sustainable and Practical Alternative
Menstrual cups have gained popularity in recent years as a sustainable and cost-effective alternative to traditional menstrual products. Made of medical-grade silicone or latex, these reusable cups collect menstrual fluid rather than absorbing it, offering numerous benefits for those who choose to use them. If you’re new to menstrual cups and considering making the switch, this beginner’s guide will provide you with essential information to help you get started. #### What is a menstrual cup? A menstrual cup is a bell-shaped device designed to collect menstrual fluid. It is inserted into the [vagina](https://nabtahealth.com/glossary/vagina/), where it forms a seal and collects the flow, holding much more liquid than a tampon or pad. The cup is reusable, offering a more sustainable option compared to disposable products. #### Advantages of menstrual cups: **Eco-friendly:** Menstrual cups reduce waste as they can last for several years with proper care. By using a cup, you can significantly decrease the number of disposable pads and tampons that end up in landfills. **Cost-effective:** Although menstrual cups have a higher upfront cost than disposable products, they are a long-term investment. Over time, using a menstrual cup can save you money since you won’t need to regularly purchase [pads or tampons](https://nabtahealth.com/articles/what-type-of-sanitary-product-is-right-for-me/). **Extended wear time:** Unlike pads and tampons, which typically require changing every few hours, menstrual cups can be worn for up to 12 hours, depending on your flow. This makes them convenient for overnight use and allows for uninterrupted activities during the day. **Lower risk of leaks and odor:** When inserted correctly, menstrual cups create a secure seal that reduces the risk of leaks. Additionally, since the fluid is collected rather than absorbed, menstrual cups do not cause the same odor issues that can arise with other products. **Health benefits:** Menstrual cups are made of hypoallergenic materials, making them suitable for people with sensitive skin or allergies. They also do not disrupt the natural pH balance of the [vagina](https://nabtahealth.com/glossary/vagina/), reducing the risk of infections. #### How to use a menstrual cup: **Choosing the right cup:** Menstrual cups come in different sizes and shapes. Consider factors such as your age, flow, [cervix](https://nabtahealth.com/glossary/cervix/) position, and whether you’ve given birth when selecting the appropriate cup. It may take some trial and error to find the perfect fit. **Sterilize the cup:** Before using a menstrual cup for the first time, sterilize it by boiling it in water for a few minutes. Ensure the cup is clean and dry before insertion. **Insertion:** Wash your hands thoroughly. Fold the cup using one of the various folding techniques available. Insert the cup into your [vagina](https://nabtahealth.com/glossary/vagina/), aiming towards the base of the spine. The cup will unfold and create a seal against the vaginal walls. **Removal:** To remove the cup, wash your hands and find a comfortable position. Gently pinch the base of the cup to break the seal, then carefully pull it out. Empty the contents into the toilet, rinse the cup with water, and reinsert if desired. #### Caring for your menstrual cup: **Empty and clean the cup:** Depending on your flow, you may need to empty the cup every 4 to 12 hours. Rinse it with water or wipe it with unscented, mild soap. Sterilize the cup between cycles by boiling it for a few minutes. **Store properly:** Keep your menstrual cup in a breathable bag or container when not in use. Avoid storing it in an airtight or plastic container to prevent odor and bacterial growth. Menstrual cups offer a sustainable, [cost-effective](https://www.lizzom.com/collections/lizzom-products), and convenient alternative to traditional menstrual products. While there may be a learning curve when initially using them, many people find them comfortable and reliable once they get accustomed to the process. By following the tips and techniques outlined in this beginner’s guide, you’ll be well on your way to a more sustainable and hassle-free period experience.