What you can expect

During the procedure

Endometrial ablation can be performed in your doctor's office. But some types of endometrial ablation are performed in a hospital, especially if you will need general anesthesia.

The opening in your cervix needs to be widened (dilated) to allow for the passage of the instruments used in endometrial ablation. Dilation of your cervix can happen with medication or the insertion of a series of rods that gradually increase in diameter.

Endometrial ablation procedures vary by the method used to remove or destroy the endometrium. Options include:

• Electrosurgery. A slender scope is used to see inside the uterus. An instrument passed through the scope, such as a wire loop, is heated and used to carve furrows into the endometrium. Electrosurgery requires general anesthesia.
• Cryoablation. Extreme cold is used to create two or three ice balls that freeze and destroy the endometrium. Real-time ultrasound allows the doctor to track the progress of the ice balls. Each freeze cycle takes up to six minutes, and the number of cycles needed depends on the size and shape of your uterus.
• Free-flowing hot fluid. Heated saline fluid is circulated within the uterus for about 10 minutes. An advantage of this method is that it can be performed in women who have an irregular-shaped uterus from abnormal tissue growth — such as intracavity lesions or uterine fibroids — that distorts the uterus.
• Heated balloon. A balloon device is inserted through your cervix and then inflated with heated fluid. Depending on the type of balloon device, the procedure can take from two to 10 minutes.
• Microwave. A slender wand is inserted through the cervix. The wand emits microwaves, which heat the endometrial tissue. Treatment usually lasts three to five minutes.
• Radiofrequency. A special instrument unfurls a flexible ablation device inside the uterus. The device transmits radiofrequency energy that vaporizes the endometrial tissue in one to two minutes. The device is then removed from the uterus.

After the procedure

After endometrial ablation, you might experience:

• Cramps. You may have menstrual-like cramps for a few days. Over-the-counter medications such as ibuprofen or acetaminophen can help relieve cramping.
• Vaginal discharge. A watery discharge, mixed with blood, may occur for a few weeks. The discharge is typically heaviest for the first few days after the procedure.
• Frequent urination. You may need to pass urine more often during the first 24 hours after endometrial ablation.