Endometrial ablation
Endometrial ablation is a procedure that uses a lighted viewing instrument (hysteroscope) and other instruments to destroy (ablate) the uterine lining, or endometrium. Endometrial ablation can be done by:
- Laser beam (laser thermal ablation).
- Heat (thermal ablation), using:
- Radiofrequency.
- A balloon filled with saline solution that has been heated to 85C (thermal balloon ablation).
- Normal saline (heated free fluid).
- Electricity, using a resectoscope with a loop or rolling ball electrode.
- Freezing.
- Microwave.
The endometrium heals by scarring, which usually reduces or prevents uterine bleeding.
What To Expect After Surgery
Endometrial ablation is usually done in an outpatient facility or hospital. The procedure may be done using a local or spinal anesthesia, although general anesthesia is sometimes used.
It takes a few days to 2 weeks to recover.
Why It Is Done
Endometrial ablation is used to control heavy, prolonged vaginal bleeding when:
- Bleeding has not responded to other treatments.
- Childbearing is completed.
- You prefer not to have a hysterectomy to control bleeding.
- Other medical problems prevent a hysterectomy.
How Well It Works
Most women will have reduced menstrual flow following endometrial ablation, and up to half will stop having periods. 1
Younger women are less likely than older women to respond to endometrial ablation. After an endometrial ablation, younger women are more likely to continue to have periods and need a repeat procedure.
Young women may be treated with either gonadotropin-releasing hormone analogues ( GnRH-As) 1 to 3 months before the procedure. This will decrease their production of estrogen and help thin the lining of the uterus (endometrium).
Risks
Problems that can happen during endometrial ablation include:
- Accidental puncture (perforation) of the uterus.
- Burns (thermal injury) to the uterus or the surface of the bowel.
- Buildup of fluid in the lungs (pulmonary edema).
- Sudden blockage of arterial blood flow within the lung (pulmonary embolism).
- Tearing of the opening of the uterus (cervical laceration).
These problems are uncommon but can be severe.
What To Think About
Regrowth of the endometrium may occur after you have endometrial ablation. This procedure is not recommended if you have a high risk for endometrial cancer.
Do not consider this procedure if you plan to become pregnant in the future.
Although this surgery usually causes sterility by destroying the lining of the uterus, pregnancy may still be possible if a small part of the endometrium is left in place. This can lead to severe pregnancy problems. Birth control of some form is needed if you have not finished menopause.
Complete the surgery information form (PDF)
(What is a PDF document?) to help you prepare for this surgery.
Citations
| Author | Kathe Gallagher, MSW |
| Author | Debby Golonka, MPH |
| Editor | Susan Van Houten, RN, BSN, MBA |
| Associate Editor | Terrina Vail |
| Associate Editor | Pat Truman, MATC |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | Liisa Honey, MD, FRCSC - Obstetrics and Gynecology |
| Last Updated | February 12, 2008 |
WebMD Medical Reference from Healthwise
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRIPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.

