Endometrial Ablation
Reduce heavy periods without removing the uterus—options include radiofrequency (NovaSure), Minerva, and thermal balloon techniques.
Endometrial ablation treats heavy menstrual bleeding by destroying (ablating) the uterine lining. Through the cervix—no abdominal incisions—we place a specialized device that delivers controlled energy (radiofrequency, thermal, or other) to the cavity. Many patients experience dramatically lighter periods or no periods afterward. Because pregnancy after ablation can be dangerous, reliable contraception or prior sterilization is required if you are premenopausal.
Fast Facts About Endometrial Ablation
Incisionless, uterus-preserving procedure
Techniques include radiofrequency (NovaSure), Minerva, and thermal balloon
Most patients go home the same day; cramping and watery discharge are common
Period flow often decreases substantially; some stop bleeding entirely
Not a contraceptive—effective birth control is required afterward
Who It May Help
- Heavy menstrual bleeding impacting quality of life or causing anemia
- Benign causes of AUB with a normal or near-normal cavity shape
- Those who have completed childbearing and want a non-hysterectomy option
- Patients who prefer a quick recovery and outpatient care
How It Works
After evaluating the uterine cavity, a device is placed through the cervix and positioned inside the uterus. Energy is delivered for a timed cycle to uniformly treat the endometrium while integrated safety checks monitor temperature, position, and cavity integrity. The device is removed, and you recover briefly before discharge.
Candidacy & Alternatives
Good candidates have heavy bleeding from benign causes, are done with childbearing, and have no significant intracavitary pathology. We typically obtain imaging (ultrasound/sonohysterogram) and, when indicated, an endometrial biopsy before the procedure. Ablation is not appropriate during pregnancy, with active pelvic infection, known or suspected endometrial cancer or hyperplasia, an IUD in place (must be removed), or when the cavity is markedly distorted by large submucosal fibroids or congenital anomalies. Alternatives include medical therapy (LNG-IUD, combined hormonal methods, progestins, tranexamic acid), hysteroscopic polypectomy/myomectomy for focal lesions, and hysterectomy for definitive treatment.
Ablation vs. Other Treatments
Endometrial Ablation
- Incisionless, quick recovery
- Reduces or stops periods for many
- Requires contraception afterward
- Does not remove fibroids outside the lining
LNG-IUD / Medications
- Reversible and non-surgical
- Effective for many with heavy bleeding
- Requires adherence; device/side effects possible
- Fertility preserved
Hysterectomy
- Definitive cure for uterine bleeding
- Surgical recovery and higher upfront risk
- No contraception needed afterward
- Fertility ends permanently
What to Expect
Most procedures take 10–30 minutes. You may feel cramping similar to period cramps for 24–48 hours. A watery, sometimes blood-tinged discharge can last 1–2+ weeks. Many return to desk work in 1–2 days. Avoid intercourse, tampons, swimming, and hot tubs until cleared—often about 1 week. Period changes evolve over several cycles.
Safety & Considerations
Expected effects include cramping, light bleeding, and watery discharge. Uncommon risks include infection, bleeding, uterine perforation, thermal injury, fluid imbalance (technique-dependent), or intrauterine adhesions. Pregnancy after ablation is high-risk (including ectopic or abnormal placentation); reliable contraception or sterilization is required if you are not postmenopausal. Prior tubal ligation can rarely be associated with post-ablation pain (postablation tubal sterilization syndrome); we review your history to reduce risks.
Before Your Visit
- ✓Complete recommended imaging and, if advised, an endometrial biopsy
- ✓Discuss contraception—plan reliable birth control after the procedure
- ✓Ask about pausing anticoagulants or supplements that affect bleeding
- ✓Arrange a ride home if sedation is planned
- ✓Use pads (not tampons) until discharge resolves and you are cleared
Frequently Asked Questions
1Will I still need birth control after ablation?
Yes. Ablation is not contraception. Because pregnancy after ablation can be dangerous, continue reliable birth control or consider sterilization if you are premenopausal.
2Will my periods stop completely?
Many patients have dramatically lighter periods and some stop bleeding, but results vary. Final flow patterns often stabilize after a few cycles.
3Can ablation treat fibroids?
It can help bleeding from small, cavity-adjacent lesions but does not remove fibroids. Submucosal fibroids are best treated with hysteroscopic myomectomy before or instead of ablation.
4How long is recovery?
Most resume routine activity within 1–2 days. Cramping typically settles within 24–48 hours, and watery discharge can last up to 1–2+ weeks.
5Do I need a biopsy beforehand?
Often yes. Depending on your age, risk factors, and bleeding pattern, we may perform an endometrial biopsy to rule out hyperplasia or cancer before ablation.
6What if bleeding continues after ablation?
Some patients need additional therapy. Options include medications, targeted hysteroscopic treatment for focal lesions, or hysterectomy if symptoms persist.
Ready to Tame Heavy Periods Without Hysterectomy?
We’ll confirm candidacy with imaging and, if needed, biopsy, review device options (NovaSure, Minerva, thermal balloon), and create a clear plan for recovery and contraception.
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