There are several different types of endometrial ablation. For some of the techniques, your doctor will pass a thin camera called a hysteroscope through your vagina and cervix to see inside your womb. Or they may use ultrasound.

Your Consultant will use instruments to destroy or remove the lining of your womb. There are different ways to do this – the main ways are listed below.

Radiofrequency

A probe is inserted through your cervix and into your womb, which will send electromagnetic energy into the lining of your womb. The energy destroys the lining.

Freezing

A thin probe is inserted into your womb to freeze its lining. Your Consultant will use an ultrasound scan to help guide them.

Heated fluid

Fluid is passed through a hysteroscope into your womb. The fluid is heated and stays in your womb for about 10 minutes. The heat destroys the lining of your womb.

Heated balloon

A balloon is inserted into your womb and heated fluid is passed into it. This expands the balloon until it touches the lining of your womb. The heat from the balloon destroys your womb lining.

Electrosurgery

A device called a resectoscope is inserted through your cervix and into your womb. The resectoscope has an electrical wire loop or rollerball that destroys the lining.

An endometrial ablation isn’t suitable for everyone. Your Consultant will advise you whether it’s right for you.

Endometrial ablation isn't recommended if:

• You want to have children or more children
• Are under 35 years old
• Have or have recently had an infection in your pelvis
• Have recently been pregnant
• Have or may have womb cancer
• If your womb is enlarged

Your Consultant may also suggest a different type of treatment if:

• You’ve had a type of surgery called myomectomy to treat fibroids
• Your uterus (womb) is an unusual shape or size
• You have fluid in your fallopian tube – this is known as hydrosalpinx
• You’ve had a caesarean delivery – your doctor may need to check the thickness of your scar before going ahead with the procedure

You might be recommended to have the NovaSure procedure as an alternative to a hysterectomy and to avoid having to take hormonal medication.

The NovaSure procedure takes 90 seconds. It involves a precisely controlled radio frequency energy being delivered through a thin handheld wand to treat the lining of the uterus. It is a quick and simple procedure which can be carried out as a day case procedure under a general anaesthetic.

It is minimally invasive and does not require incisions. It can be carried out at any time during the menstrual cycle.

You'll be able to go home the same day and can usually return to work within one or two days.

You’ll probably have some vaginal bleeding for a few days after your procedure, like a light period. Sometimes this can last up to a month. You can use sanitary towels until the bleeding stops – it’s best not to use tampons.

If your discharge becomes smelly or changes colour or you have pain and feel unwell, you may have an infection. You should contact the unit where you had your surgery or your GP.

Wait until any vaginal discharge or bleeding has stopped before you have sex. And most importantly, wait until you feel ready.

You may have some stomach cramps. Your hospital may give you some pain-relief medicine before you leave. Or you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your nurse or pharmacist for advice.

You may feel tired for the first few days. Ask family or a friend for some help and support with day-to-day activities, such as food shopping or looking after children if you have them.

Depending on your job, you should be able to go back to work two to five days after your endometrial ablation. But this will depend on how physically demanding your job is, and how many hours you work. You may need to return to work gradually over a week or so.

It’s unlikely that you can get pregnant after endometrial ablation but it’s still possible - so you’ll need to use contraception after the procedure until you’ve been through the menopause.

If endometrial ablation isn’t right for you, there may be some other options available to you. Your doctor may suggest you try some of these before you have endometrial ablation.

Intrauterine system Mirena Coil is a plastic T-shaped device that’s put in your womb and releases a hormone. It works by thinning the lining of your womb and reducing bleeding.

Medicines such as the combined oral contraceptive pill or tranexamic acid may reduce the amount of blood you lose during each period.

If all other treatment options aren’t suitable, you may be offered a hysterectomy to remove your womb. But this should be a final option because hysterectomy has more associated complications than endometrial ablation.