An endometrial ablation is a procedure your doctor might consider if you bleed between your menstrual periods, have a heavy flow, or have periods that last a long time. If medicines don’t help, your doctor might suggest endometrial ablation. It can curb the bleeding or stop it totally.
Heavy menstrual bleeding can have many causes. These include hormonal changes, fibroids, and/or polyps growing in your uterus.
Endometrial ablation removes the endometrium, which is the lining of the uterus. In most cases, your period will return to normal or light flow, although sometimes, it will stop completely.
Reasons for Endometrial Ablation
Endometrial ablation can put an end to heavy bleeding that gets in the way of your everyday life (maybe you need to change your tampon or pad every hour, or you bleed for more than a week). If your bleeding causes other health problems, such as anemia, this procedure could also help.
Still, endometrial ablation isn’t right for everyone. If you’re postmenopausal, you shouldn’t have it done. It’s also not recommended if you have:
- Uterine, cervical, or endometrial cancer
- Pelvic inflammatory disease (PID)
- A vaginal or cervical infection
- A weak wall to your uterus
- An infection of the uterus
- An intrauterine device (IUD)
- A disorder of the uterus or endometrium
Also, if you’re pregnant or want a baby in the future, don’t have endometrial ablation. Discuss birth control with your doctor.
Endometrial Ablation Procedure: How Does It Work?
Endometrial ablation is minimally invasive. The doctor doesn’t make any surgical cuts. Instead, they insert very thin tools through your vagina to reach your uterus. The exact tools depend on the type of ablation they do.
The most common are:
Hydrothermal ablation. Your doctor gently pumps fluid into your uterus, then heats it. After 10 minutes, this destroys your uterine lining.
Balloon therapy. Your doctor guides a thin tube with a special balloon on the end into your uterus. Heated fluid fills the balloon, which then expands and destroys the lining.
High-energy radio waves. Your doctor puts an electrical mesh into your uterus and expands it. Then, energy and heat sent by strong radio waves damage the lining, which your doctor removes with suction.
Freezing. A thin probe with a very cold tip freezes off the lining of your uterus. Your doctor may call this “cryoablation.”
Microwave ablation. A special wand applies microwave energy to your uterine lining, which destroys it.
Electrical ablation. Your doctor can use an electric current to destroy the lining of your uterus, but this method isn’t as commonly used as the others.
Sometimes, doctors can do endometrial ablation in their office. Or you may need to go to the hospital.
Benefits of Endometrial Ablation
The main reason people choose endometrial ablation is to manage heavy menstrual bleeding that interferes with daily life.
Potential benefits include:
- Lighter periods
- Bleeding that last fewer days
- Improved quality of life
- Improvement in anemia (better iron levels due to less bleeding)
- Avoiding a hysterectomy
Endometrial ablation doesn’t remove your uterus, so recovery is usually faster than with bigger surgeries.
Endometrial Ablation Risks and Side Effects
Endometrial ablation is generally safe. But like any medical procedure, it may cause some issues.
Possible problems include:
- Infection
- Bleeding
- A small tear or hole in the uterus
- Burns or injury to nearby organs
- Fluid absorption problems (rare)
Short-term side effects are more common and include:
- Cramping, similar to period cramps
- Nausea
- Needing to pee more often for a day or so
- Watery or bloody vaginal discharge that may last a few weeks
Call your doctor if you have:
- Fever or chills
- Serious belly pain
- Bad-smelling vaginal discharge
- Heavy bleeding that doesn’t get better after a couple of days
- Trouble peeing
These symptoms could be signs of bigger problems, so get them checked by your doctor.
Endometrial Ablation Recovery
It shouldn’t take you long to heal from an ablation. Most women are back to their normal routine within a few days.
You may have some cramping and bleeding for a few days and a watery or bloody discharge for up to three weeks. It’s also common to have nausea and an urge to pee for the first 24 hours.
Your doctor will advise you not to have sex, use tampons, or douche for a few days. They may also put limits on your activity. If you need medicine for pain, ask your doctor which over-the-counter medicines are safe to take. Don’t take aspirin. It could make you bleed more.
The results of endometrial ablation may not last forever. After a few years, your periods may start to get heavier and longer again. Let your doctor know if that happens. You may need a different treatment.
Endometrial Ablation Cost
The cost of endometrial ablation can vary a lot depending on where you have the procedure and the method your doctor uses.
Without insurance, the price may range from about $2,500 to $12,000 or more. But most health insurance plans cover some or all of the cost if the procedure is considered medically necessary.
Your out-of-pocket cost depends on things such as:
- Your insurance plan
- Whether the doctor or hospital is in-network
- Whether you get the procedure in a clinic or hospital
- The type of ablation technique used
For example, someone with Medicaid may pay around $500 to $1,000 out of pocket, while people with private insurance may pay more or less depending on their deductible and coverage.
If you want to estimate the cost ahead of time, you can:
- Ask the doctor’s office or hospital billing team for a “good faith” estimate
- Use a hospital cost-estimator tool
- Call your insurance provider
You can also check independent price tools, such as:
- Procedure Price Lookup (Centers for Medicare & Medicaid Services)
- Health Care Price Toolkit (Health Care Cost Institute)
- Valenz Bluebook (formerly Healthcare Bluebook)
If you don’t have insurance, ask about a self-pay discount. Many hospitals and clinics offer lower prices for people paying out of pocket. These discounts often bring the cost closer to what Medicare or insurance plans typically pay.
Endometrial Ablation FAQs
How many years does an endometrial ablation last?
It depends. You may have lighter periods for good, or your bleeding may slowly come back after a few years. About 1 in 4 people who have an ablation end up needing another surgery, so let your doctor know if your heavy bleeding returns. You’ve got more than one treatment choice.
Does endometrial ablation cause weight gain?
Usually not. Endometrial ablation doesn’t change your hormones or metabolism, so it isn’t known to cause weight gain. That said, it's common to feel a little bloated for a short time after. Your body may hold on to extra fluid while it heals, but that should go away as you recover.
How effective is endometrial ablation for treating heavy periods?
It works well for many people. Most notice their periods become much lighter, and some even stop having periods. But the goal is to lessen bleeding to an extent where it no longer disrupts your daily life.
Can you get pregnant after endometrial ablation?
It’s uncommon, but pregnancy can still happen after the procedure. But the uterus may not hold a baby in a safe way, which boosts your chances of miscarriage or other serious problems. That’s why your doctor will suggest using birth control if you have sex and could get pregnant.
