In endometrial ablation, the doctor treats the lining of the uterus by destroying a thin layer called the endometrium. The endometrium is the inner portion of the uterus that is shed each month during menstruation. This procedure is performed by a gynecologist. It is usually done as an outpatient and the patient is able to go home the same day. Depending on the type of procedure used, up to 50% of patients treated with this technique may have no menstrual flow for up to five years, and up to 90% have improvement in their menstrual flow.

An endometrial ablation can be completed in many ways, and at least five different instruments have been approved by the Food and Drug Administration (FDA) to perform this surgery. Successful removal of the lining of the uterus can be accomplished using many different techniques, the most common of which are:

Hysteroscopy with rollerball electrocautery

A telescope placed into the uterus and with electricity applied to a small ball mounted on the end of the telescope.

Fluid filled balloon (Thermachoice©)

A thin balloon is inserted in the uterus and filled with superheated water.

Bipolar electrocautery (Novasure©)

A mesh device with electricity introduced into the uterus. A computer is used to measure when the lining of the uterus has been fully treated.

Sometimes the doctor may give a patient some medication to thin the lining of the uterus prior to performing the procedure in order to increase the chance of a successful outcome. Newer procedures like the Novasure© do not require medical therapy in preparation for surgery.

An endometrial ablation should not be used with women who may want to become pregnant. It is used only in the treatment of abnormal bleeding, and is not indicated for use in patients with uterine prolapse, endometriosis, pelvic pain, or gynecologic cancers.