Endometrial ablation is a surgery that destroys the lining of the uterus. The lining of the uterus is called the endometrium. The goal of endometrial ablation is to reduce how much you bleed during periods, also called menstrual flow. In some people, menstrual flow may stop completely.

No cuts are needed for endometrial ablation. Your health care provider inserts slender tools through the vagina and into the natural opening of the uterus, also called the cervix.

The tools vary, depending on the method used to ablate the endometrium. Methods might include extreme cold, heated fluids, microwave energy or high-energy radiofrequencies.

Endometrial ablation can be done in your health care provider's office or in an operating room. The size and condition of your uterus, your health and other factors, such as the practice of your provider, can play a role in which endometrial ablation method you'll have.

Endometrial ablation is a treatment for very heavy menstrual blood loss. You might need an endometrial ablation if you have:

• Unusually heavy periods, sometimes defined as soaking a pad or tampon every two hours or less.
• Bleeding that lasts longer than eight days.
• A low red blood cell count from excessive blood loss. This is called anemia.

To reduce how much you bleed during periods, your health care provider might suggest birth control pills or an intrauterine device (IUD). Endometrial ablation is another option.

Endometrial ablation generally isn't recommended for women after menopause. It also isn't recommended for women who have:

• Certain uterus conditions.
• Cancer of the uterus, or an increased risk of cancer of the uterus.
• An active pelvic infection.
• A desire for future pregnancy.

Complications of endometrial ablation are rare and can include:

• Pain, bleeding or infection.
• Heat or cold damage to nearby organs.
• A puncture injury of the wall of the uterus from surgical tools.

Future fertility

You can still get pregnant after endometrial ablation. But the pregnancy is higher risk to you and the baby. The pregnancy might end in miscarriage because the lining of the uterus has been damaged. The placenta may not implant correctly, causing it to grow into the uterus wall. Or the pregnancy might occur in one of the fallopian tubes or cervix instead of the uterus. This is called an ectopic pregnancy.

If you have an endometrial ablation, long-lasting or permanent birth control is advised to prevent pregnancy.

In the weeks before the procedure, your health care provider typically will:

• Perform a pregnancy check. Endometrial ablation can't be done if you're pregnant.
• Check for cancer. A thin tube is inserted through the cervix to collect a small sample of the endometrium to be tested for cancer.
• Examine the uterus. Your provider may examine your uterus using an ultrasound. You also may have a procedure that uses a thin device with a light, called a scope, to look at the inside of your uterus. This is called hysteroscopy. These tests can help your provider choose which endometrial ablation procedure to use.
• Remove an IUD. Endometrial ablation isn't done with an IUD in place.
• Thin your endometrium. Some types of endometrial ablation work better when the uterine lining is thin. Your health care provider might have you take medicine to thin the lining. Another option is to do a dilation and curettage (D&C). In this procedure, your provider uses a special tool to remove extra tissue from the lining of the uterus.
• Talk about anesthesia options. Ablation often can be done with sedation and pain medicine. This may include numbing shots into the cervix and uterus. But, sometimes general anesthesia is used. This means you're in a sleep-like state during the procedure.

It might take a few months to see the final results. But endometrial ablation often reduces the amount of blood lost during periods. You may have lighter periods. Or you may stop having periods entirely.

Endometrial ablation isn't a sterilization procedure. You should continue to use birth control. Pregnancy might still be possible, but it will likely be dangerous to you and the baby. It may end in miscarriage. Permanent sterilization is also an option to avoid pregnancy after the procedure.