Endometrial Ablation

Overview

Endometrial ablation is a minimally invasive procedure used to treat abnormal uterine bleeding, especially heavy menstrual bleeding (menorrhagia). The goal is to destroy (ablate) the endometrial lining of the uterus — the source of menstrual bleeding — thereby significantly reducing or stopping periods altogether.

This procedure is not a form of contraception and is only suitable for people who do not wish to become pregnant in the future.

Who It’s For

Endometrial ablation may be an effective treatment if you:

Experience heavy or prolonged periods that affect your quality of life
Have tried (or are unsuitable for) medical treatments such as the Mirena or hormonal therapy
Have completed your family and do not plan further pregnancies
Have a normal-sized uterus and no large fibroids or suspected cancer

It is not suitable if:

You have active pelvic infection
You are postmenopausal
You have a history or suspicion of endometrial hyperplasia or malignancy
You have significant intracavitary pathology like large fibroids or a distorted cavity

How It’s Performed

Endometrial ablation is usually performed as a day procedure under general anaesthetic using the Hologic NovaSure device.

A slender device is placed through the cervix and deploys a flexible, triangular netting inside the uterus.

This netting expands to fit the unique shape of the uterus, and then delivers precisely measured radiofrequency energy (heat) to the entire lining of the womb for about 90 seconds. The energy destroys the tissue that causes bleeding, after which the device is simply withdrawn, leaving nothing behind.

The procedure typically takes 10–15 minutes and is performed in conjunction with a diagnostic hysteroscopy and endometrial biopsy.

Endometrial ablation involves a thin instrument being inserted through the cervix which then unfolds a triangular netting inside the uterus. This delivers radiofrequency heat for about a minute and a half to permanently destroy the uterine lining (the endometrium). The device custom-fits the uterus, ensuring the entire inner surface is treated quickly and without the need for an incision.

Recovery

Cramping and spotting or watery discharge are common for up to 2–4 weeks.
Most patients return to work and normal activities within 1–3 days.
You should avoid swimming, intercourse, and tampons for around two weeks or as advised.

Benefits and Success

85–95% experience lighter periods or complete cessation
Over 50% stop bleeding entirely
High satisfaction and low complication rate
Not a sterilisation method, but pregnancy afterward is rare and potentially dangerous — contraception is still recommended

Risks

Cramping, discharge, or infection
Failure to improve symptoms (requiring repeat treatment or hysterectomy)
Rarely, uterine perforation or thermal injury to surrounding structures
Post-ablation tubal sterilisation syndrome (rare complication in patients with prior tubal ligation)

Alternatives

Mirena (levonorgestrel-releasing IUD)
Combined or progesterone-only oral contraceptives
Tranexamic acid or NSAIDs
Hysterectomy (for definitive treatment)
Uterine artery embolisation (if fibroids contribute)

Dr Sam Holford

Is ablation suitable for you?

If you have further questions, you’ll have the opportunity to discuss everything during your consultation — including whether surgery is right for you and what your alternatives are. All decisions are made together.

Book an appointment

FAQs

Will my periods stop completely after an endometrial ablation?

Many people find their periods stop completely, but it's more common for them to become much lighter and more manageable. While over 50% of people report no periods (amenorrhoea) after the procedure, the main goal is a significant reduction in bleeding.

Is endometrial ablation a form of contraception?

No, it is not a form of sterilisation or contraception. While pregnancy is very unlikely after an ablation, it can still happen and carries serious risks. It is essential to use reliable contraception until after menopause.

How long is the recovery after an endometrial ablation?

Recovery is usually very quick. Most people can return to work and normal daily activities within a day or two. You may experience some period-like cramping and a watery, blood-stained discharge for a few days to a few weeks.

What happens if the endometrial ablation doesn't work?

Endometrial ablation is highly effective for most people. If it doesn't sufficiently reduce your bleeding, other options can be explored, including hormonal treatments like the Mirena IUD or, for a definitive solution, a hysterectomy.

Is the procedure painful?

The procedure itself is performed under a general anaesthetic, so you will be completely asleep and feel no pain. Afterwards, it is common to have some period-like cramping, which can usually be managed well with simple pain relief medication like ibuprofen or paracetamol.

Patient Resources

Why Choose Me?

I offer a thoughtful, individualised approach to heavy menstrual bleeding and continue to contribute to national guidelines on diagnosis and management. I perform high-quality diagnostic ultrasound and hysteroscopy to ensure ablation is safe and likely to be effective. I will support you through a clear decision-making process, help you explore alternatives, and deliver excellent follow-up care. For many, endometrial ablation is a life-changing alternative to long-term medication or major surgery.

Please note: This information is general in nature and not a substitute for medical advice tailored to your specific situation.