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Dr Jan AdlamGynaecologist & Urogynaecologist

SPECIALIST GYNAECOLOGICAL SURGERY

Endometrial ablation

Heavy periods can shape your whole month. Ablation treats the womb lining to reduce bleeding, without removing the womb. I assess whether it fits your symptoms, anatomy and future plans, and tailor treatment around what matters to you.

Could it suit me? Compare treatment options
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UNDERSTANDING THE TREATMENT

Treat the lining. Keep the womb.

The endometrium is the lining that sheds during a period. Ablation destroys this tissue to reduce bleeding. It is a lasting treatment, so the decision includes your future as well as your current symptoms.

TREATED

Womb lining

The target is the tissue responsible for menstrual bleeding.

RETAINED

Womb & cervix

They stay in place. Ablation is different from hysterectomy.

RETAINED

Ovaries

They continue their hormone function. Ablation does not bring on surgical menopause.

Keeping the womb after ablation does not make a future pregnancy safe.

MY SPECIALIST ASSESSMENT

The right operation starts with the right diagnosis.

I look beyond how heavy the bleeding is. Pain, previous treatments, scan findings, earlier womb surgery and your priorities all influence whether ablation is likely to help.

When it may be a good fit

  • Heavy periods before menopause are disrupting your life.
  • You do not want a future pregnancy.
  • The lining assessment is reassuring and the cavity is suitable for the device.
  • Medicines or a hormonal IUD have not helped enough, are unsuitable, or you prefer a surgical option after discussing the choices.

When a different plan is needed

  • Pregnancy now or a wish for pregnancy in future.
  • Unexplained bleeding, suspected cancer or abnormal precancerous lining changes.
  • Bleeding after menopause or an active infection.
  • A cavity shape, size or previous operation that makes treatment unsafe.

TREATMENT TAILORED TO YOU

Which option matches your priorities?

Your preference matters alongside the diagnosis. My surgical expertise includes choosing when a focused procedure is enough and when a more comprehensive operation is worthwhile.

Medicines

May suit: wanting to avoid a procedure or keep future pregnancy options open.

Tranexamic acid, suitable anti-inflammatories or hormonal treatment can reduce bleeding. They need ongoing use and have individual precautions.

Tranexamic acid

Hormonal IUD

May suit: wanting bleeding control and reversible contraception.

A levonorgestrel IUD such as Mirena often reduces bleeding. Spotting is common initially; suitability depends on your health and the cavity.

Mirena & hormonal IUD
THIS PROCEDURE

Endometrial ablation

May suit: wanting a short procedure for heavy periods after completing childbearing.

The womb stays, recovery is usually shorter than after hysterectomy, and lighter periods are the goal. Further treatment may be needed.

How I perform ablation

Hysterectomy

May suit: wanting definitive treatment for uterine bleeding, or having other womb problems that justify removal.

It removes the womb and prevents future pregnancy. I tailor the surgical route to your circumstances; recovery and risks are greater than with ablation.

Explore hysterectomy

A polyp or fibroid inside the cavity? Targeted hysteroscopic removal may address the cause. I decide whether this is sufficient or whether a separate bleeding treatment is also appropriate.

MY SURGICAL APPROACH

A planned procedure, with safety checks throughout.

I most often use NovaSure, a radiofrequency ablation system, in theatre under a short general anaesthetic. The treatment passes through the cervix, so there are no abdominal cuts. We agree the procedure and anaesthetic plan beforehand.

  1. Check the cavity

    I use hysteroscopy to inspect the inside of the womb and confirm that the findings fit the agreed plan. The lining assessment must be reassuring before ablation.

  2. Treat the lining

    The device is fitted to the cavity. After its safety checks, controlled radiofrequency energy treats the lining. The device is then removed; no implant is left behind.

  3. Recover with a plan

    Most patients go home the same day once comfortable and ready. You receive pain-relief advice, recovery instructions and a follow-up plan.

The energy treatment takes only a short part of the visit. Allow time for admission, anaesthesia and recovery. If findings or safety checks make ablation unsuitable, I will not proceed with it.

BEFORE TREATMENT

Make sure the plan is safe and practical.

Assessment first

  • Ultrasound to assess the womb and cavity, with hysteroscopy as needed.
  • A sample of the lining to check for abnormal cells; the result informs whether ablation can proceed.
  • A blood count and treatment for anaemia where needed.
  • Review of previous womb surgery, sterilisation, medicines and contraception. An existing IUD must be removed before ablation.

Plan for the day

  • Follow your fasting and medicine instructions. Do not stop prescribed medicines without advice.
  • Avoid pregnancy before treatment and tell me if it is possible. A pregnancy test may be required.
  • Arrange transport and an adult to stay with you after anaesthesia.
  • Allow a few quieter days and discuss time off work before booking.

RECOVERING AT HOME

Expect a short recovery, with some variation.

  1. First few days

    Period-like cramps and tiredness are common. Use the recommended pain relief, rest when needed and start gentle activity as you feel able.

  2. Following weeks

    Light bleeding or watery, blood-stained discharge can continue for several weeks. Use pads and wait until bleeding and discharge settle before vaginal penetration or tampons, following your discharge advice.

  3. Return to routine

    Many patients return to work in about two to five days; physical work or additional treatment may need longer. Follow your anaesthetic instructions for driving and other activities.

BENEFITS AND FOLLOW-UP

Success means a worthwhile improvement in your life.

Many patients have much lighter periods; some stop bleeding altogether. A guarantee of no further periods would be unrealistic. Allow a few months to assess the new pattern.

Agree what improvement means

Fewer flooded clothes, less disruption to sleep or work, and recovery from anaemia may matter more than having no periods. I review the bleeding pattern and any pain with you.

If symptoms persist or return

Further assessment and treatment, including hysterectomy, may be needed. Repeat NovaSure ablation is not a routine option: these devices are not designed for repeat treatment.

Report new or recurrent bleeding or pelvic pain, including bleeding after menopause. Tell any clinician assessing it that you have had an ablation; scarring can make the lining harder to sample.

INFORMED CHOICE

Understand the risks as well as the benefits.

During or soon after surgery

Risks include infection, bleeding, damage to the cervix or a hole in the womb. Rarely, heat can injure nearby organs such as the bowel or bladder, requiring further surgery. General anaesthesia also has risks.

Problems that can develop later

Bleeding may continue or return. Scarring can trap blood and cause pain; new cyclical pain can occur, particularly after previous sterilisation. Some patients need further surgery.

I discuss your individual risks and alternatives before consent. Ablation does not treat cancer and does not remove the need to investigate future symptoms.

COMMON QUESTIONS

Questions patients often ask

Will my periods stop completely?

They may, but lighter, more manageable bleeding is the aim. Some patients continue to have periods or need more treatment later.

Can I still become pregnant?

Yes. Ablation is not sterilisation, and pregnancy afterwards can be dangerous. It is only suitable if you do not want a future pregnancy. Agree effective contraception before treatment.

Does ablation cause menopause?

It does not remove the ovaries or stop their hormone function. If bleeding stops after ablation, that alone does not mean you have reached menopause.

Will it treat painful periods as well?

Some patients notice less cramping, but ablation is a bleeding treatment. Significant pain needs its own assessment, especially if adenomyosis or endometriosis may be contributing.

Could hysterectomy be the better choice for me?

Yes, depending on your symptoms, anatomy, previous treatment and preferences. I can discuss both procedures and explain which is more likely to address your particular problem.

Can I use HRT later?

Often, yes. The womb remains, so systemic oestrogen usually still needs a progestogen to protect any remaining lining. Your HRT should be prescribed around your individual circumstances.

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YOUR NEXT STEP

Choose treatment around your life.

Bring your scan reports, medicine list and a note of how bleeding affects you. I will explain whether ablation, another focused procedure or hysterectomy best fits your needs.

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