What is a radiofrequency endometrial ablation?

A radiofrequency endometrial ablation is an operation that uses radiofrequency energy to thin the lining (endometrium) of your uterus (womb). After the operation most women have a noticeable reduction in their periods and, for some women, periods stop altogether.

What are the benefits of surgery?

The most common reason for having an endometrial ablation is to relieve the symptoms of heavy periods (abnormal uterine bleeding).

Most women will have much less bleeding when they have their period. Pain is usually significantly reduced, although for some women mild cramping may still happen.

Just under half of the women who have the operation will not have periods anymore.

Are there any alternatives to surgery?

Heavy periods can be treated using a variety of non-hormonal and hormonal oral (by mouth) medications.

Other alternatives include an IUS (intra-uterine system — an implant containing a synthetic form of the hormone progesterone that fits in your womb) but these are usually tried before surgery is recommended.

What will happen if I decide not to have the operation?

Your doctor will continue to try to control your symptoms with medication, or you can continue without treatment. For some women this is acceptable if the cause of the symptoms is not serious.

What does the operation involve?

The operation can be performed under a local or general anaesthetic. The operation usually takes less than 20 minutes.

Your gynaecologist will place a radiofrequency probe into your womb. They will expand a mesh from the probe in your womb. Your gynaecologist will check that your womb is intact and then pass radiofrequency energy through the mesh. The radiofrequency energy will be delivered for about 90 seconds, thinning the lining of your womb.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and can even cause death.

General complications of any operation

• Feeling or being sick.
• Bleeding or discharge, lasting up to 4 weeks.
• Infection.
• Allergic reaction to the equipment, materials or medication.
• Venous thromboembolism (VTE) — this is a blood clot in your leg (deep-vein thrombosis - DVT) or one that has moved to your lung (pulmonary embolus).
• Chest infection — your risk will be lower if you have stopped smoking and you are free of Covid-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific early complications

• Failed procedure.
• Making a hole in your womb with possible damage to a nearby structure. If your gynaecologist is concerned that an organ has been damaged, you may need keyhole surgery or another operation  involving a larger cut.
• Thermal burns, if radiofrequency energy passes through the wall of your womb and damages nearby structures such as your bowel.

Specific late complications

• Continued bleeding or pain needing another endometrial ablation or a hysterectomy.
• Haematometra, where blood and other menstrual fluid collect in pockets in your womb.
• If you have been previously sterilised, tubal sterilisation syndrome. Menstrual fluid gets trapped in a fallopian tube, causing pain.
• Pregnancy problems, if you become pregnant after an endometrial ablation.

Consequences of this procedure

• Pain.

How soon will I recover?

You should be able to go home the same day.

You may get some cramps and mild bleeding similar to a period. Rest for 1 to 2 days and take painkillers if you need them.

You should be able to return to normal activities after 2 to 4 days. Most women are fit for work after about a week.

You should expect to have some bleeding or discharge for up to 4 weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

The operation is not recommended for women who still want children.

Summary

An endometrial ablation is a common gynaecological operation. It helps relieve the symptoms of heavy periods. You should get less bleeding and pain.

The operation and treatment information on this page is published under license by Healthdirect Australia from EIDO Healthcare Australia and is protected by copyright laws. Other than for your personal, non-commercial use, you may not copy, print out, download or otherwise reproduce any of the information. The information should not replace advice that your relevant health professional would give you. Medical Illustration Copyright © Medical-Artist.com.

For more on how this information was prepared, click here.