Endometrial Ablation

Endometrial ablation destroys the lining of the uterus to reduce heavy menstrual bleeding. A surgeon works through the cervix with heat, cold or a laser. The uterus stays. Pregnancy afterward is unlikely but possible, and it carries serious risk.

The bleeding falls, and the reason for it goes unnamed. An early series of 18 women treated for heavy bleeding reported lighter periods and milder premenstrual symptoms afterward.¹ Cause-based care asks what drives the bleeding first and keeps the organ working when it can.

The same logic separates removal from destruction elsewhere in the pelvis. For an ovarian endometriosis cyst, a review of best evidence named removal of the cyst wall the preferred method for pain and fertility.² Excision is the standard for endometriosis for the same reason.