Endometrial Ablation

[MsWhistledown]

Hello warriors,

I was hoping to hear from anyone who has had an endometrial ablation. It would be good to hear your experience of the procedure and if it made any difference to your symptoms? Did your periods stop or become much lighter? Or did it not have much of a positive effect? I’d be really grateful to hear from you.

I have what is considered mild adenomyosis and possibly superficial endometriosis. No deep infiltrating endometriosis found.

I had a hysteroscopy last week and some biopsies taken. Surgeon said he couldn’t see anything wrong. He suggested next step I could consider is an endometrial ablation. I am considering this before making a final decision on having a hysterectomy. I’m wondering if it might be worth trying this first.

Thank you.

[Pumpkinjellyfish]

hi,

I had an endometrial ablation about 18 months ago. I’ve always had extremely heavy painful periods which were controlled with TXA and pain killers.

The surgery itself wasn’t painful, it was the referred shoulder tip pain which was agony for two days after, and I don’t tolerate opiates so I managed with paracetamol and ibuprofen.

I was up and about pretty much straight away although I couldn’t stand straight without a pulling type pain for about 3 days.

Afterwards I had some watery pinkish bleeding for three or so weeks. Then no periods for about 4 months. After that they gradually came back although very lightly. Even then it wasn’t enough to need a tampon but definitely need a liner.

I believe the literature suggests an ablation should be done straight after a period but due to NHS waiting lists and cancellations etc, I was offered surgery on a day and happened to come on my period that day, so the endometrium would have been at its thickest and I don’t believe the radio waves would’ve infiltrated deep enough to be long term effective. This is just my understanding and opinion.

That being said the bleeding is a lot less so ultimately worth it.

I have had increasing pain over the last few months with barely any bleeding. I have a polyp in my uterus too which causes bleeding between periods, so I’m back on the waiting list for more surgery. I think I have endometrial tissue around my bowels and bladder and the ablation has done nothing to help this but at least the pain is more manageable with lighter periods

Hope that’s helpful info for you

[MsWhistledown in reply to Pumpkinjellyfish]

Thank you. It’s very helpful. I’m thinking it’s worth a try. The idea of having next to no period or no period at all would definitely improve my quality of life.

[AllthatGlitters]

yes I have had the novasure endometrial ablation twice and it’s definitely helped me. I would be in labour pains, bleeding through clothing, for months one end. It’s lighter periods but I did have a very bad period when away in Spain. However this isn’t a frequent thing anymore. It’s worth a try! X

[MsWhistledown in reply to AllthatGlitters]

Thank you. That’s really helpful. It sounds like it is worth a try x

[ClaudiaGrace]

Hey, I had this for superficial endometriosis, didn’t have issues with periods before as I’m on the mini pill with no periods so can’t comment on that but it did reduce my pain for about 6 months. Then it came back, it got worse but I think that’s likely due to stress and the fact that I didn’t know at the time about ways to manage it with life style. Would highly recommend reading heal endo and doing things from there to hopefully reduce the chances of it growing back. This and seeing a pelvic floor physio has helped me to significantly reduce my pain without a second surgery.

It may also be worth looking in to the evidence base for surgery for superficial endo as I was under the impression that it wasn’t great. I assume your pain is bad enough to warrant the risks of these surgeries? As they’re all about symptom management rather than cure. Is your surgeon in an endometriosis centre as they also collect their own data so he should be able to tell you about the chances that it’ll reduce pain etc.

[ClaudiaGrace]

For example after a quick search:

link.springer.com/article/1...

pmc.ncbi.nlm.nih.gov/articl...

Plus people are probably going to come on here and tell you that ablation is not acceptable and you should have excision because that seems to be the dominant narrative and because the NICE guidelines says ‘consider excision over ablation’. However I was told by someone very specialist that it’s not this simple and you use the appropriate approach for the specific presentation of the disease, often using a combination in reality. This study clearly shows no difference between the two approaches in a randomised control trial which is gold standard.

sciencedirect.com/science/a...

Hope that’s helpful

[MsWhistledown in reply to ClaudiaGrace]

Thank you ClaudiaGrace. This is all very helpful. I have seen a specialist endo surgeon and yes he said excision is superior to ablation. Which I can understand in most cases will be. However, sorry if I have confused things with my post. What I am looking into having done is not ablation of my superficial endo. It’s ablation of my endometrial layer of the uterus. Which is done to try and stop or make much lighter, heavy periods. This is what I am thinking of having done to see if it helps my symptoms so that I don’t have to have or can delay a hysterectomy.

I have already discussed with the surgeon if I have a hysterectomy with him in the future, he will excise and superficial endometriosis.

[ClaudiaGrace in reply to MsWhistledown]

Ahh I see, interesting I have not heard of this. Sorry probably my misinterpretation where I was unfamiliar with it.

It’s really interesting that so many people say excision over ablation, even surgeons, seems an unhelpful over simplification that I have seen on here causes a lot of anxiety for people who have ablation.

Best of luck with it all, fingers crossed it has the desired effect.

[MsWhistledown in reply to ClaudiaGrace]

Thank you. Yes I think it shows how under researched this horrible condition is and research and understanding needs to be ramped up.

Thank you again x

[ClaudiaGrace in reply to MsWhistledown]

Yeah big time, on the plus side things do seem to be going in that direction so fingers crossed for better times ahead!