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Endometrial ablation, a medical procedure that destroys the uterine lining, is sometimes recommended to women who suffer from severe uterine bleeding during menstruation. The procedure can greatly reduce and even make periods stop altogether, since the endometrium, the lining of the uterus, is the source of menstrual bleeding. To women with hemorrhagic periods, endometrial ablation can provide immense relief very quickly. 

Endometrial ablation can be carried out in multiple ways — using heat, freezing, laser, electricity,  or microwaves. NovaSure endometrial ablation, a procedure that uses radiofrequency to ablate the endometrium, is a popular form of the procedure right now. 

Though endometrial ablation can improve a woman's quality of life a great deal, as with any other medical procedure, it also carries some risks. 

When Are You Not A Candidate For Endometrial Ablation?

Contraindications for endometrial ablation include active vaginal and cervical infections, pelvic inflammatory disease (PID), uterine abnormalities, past vertical c-section incisions, recent pregnancy, having undergone surgery for uterine fibroids, and having an intrauterine device in place. 

Endometrial ablation is also not an option for women who would still like to have more children in future, as the procedure makes pregnancy incredibly risky. Women who undergo an endometrial ablation need to arrange for a permanent birth control method. Essure, a tubal ligation method that involves inserting very small implants into the fallopian tubes, is often used in conjunction with NovaSure endometrial ablation.

What Are The Possible Post-Procedure Complications Of Endometrial Ablation?

Post-procedure bleeding and infection are risks linked to practically any surgical or semi-surgical procedure. In addition, there is the risk that the uterine wall or bowel will tear. The possibility of a fluid-overload into the blood stream also exists. 

Long-Term Complications Of Endometrial Ablation

In some cases, endometrial ablation will fail right off the bat, and patients will never receive the relief from hemorrhagic periods that they were hoping for. This can be due to an incomplete ablation of the endometrium, or due to performing the procedure despite the presence of uterine fibroids.

Unfortunately, there is now evidence to suggest that even after an endometrial ablation that initially appeared to be very successful, a significant amount of patients experience long-term complications. One study even suggests that as many as one in four women who underwent endometrial ablation will end up with a hysterectomy! This is often due to the sudden onset of pain, heavy bleeding, or both, years following the procedure. 

Post-ablation syndrome is another occurrence that has been discussed in medical literature, with some estimating its prevalence to fall somewhere between eight and 33 percent. This post-ablation syndrome is a potential occurrence after a woman who previously underwent a tubal ligation then has an endometrial ablation. It presents as a cyclical pain that results from bleeding into the already obstructed tubes. Some women anecdotally report suffering through years of intermittent yeast infections and vaginal odor prior to being diagnostic with post-ablation syndrome. 

What Now?

In the case of post-ablation syndrome, a salpingectomy (removal of the fallopian tubes) and the removal of any present adhesions is the suggested treatment. In other cases, a hysterectomy may prove to be necessary. Women who suffer from pain and heavy bleeding following an endometrial ablation should always seek medical attention to discuss their treatment options.

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