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Endometrial Ablation Risk Complications

Endometrial Ablation Risk Complications

For women suffering with heavy menstrual bleeding, the NICE guidelines (National Institute for Health and Care Excellence) state that conservative treatment should be offered and tried before surgery. Women should be offered medication in the form of progestogen, oral contraceptive, tranexamic acid or non-steroidal anti-inflammatory drugs.

Heavy menstrual bleeding is a common disorder. It is estimated that 1 in 20 women in the UK aged 30–49 years consults her GP each year – approximately 1.5 million women in England and Wales. Referrals for menstrual disorders account for about 20% of all referrals to specialist gynaecology services.

It is important to rule out all organic and structural causes of heavy menstrual bleeding before considering ablation. The technique is not suitable for women who wish to maintain fertility. It can result in infertility or an inability to carry a baby to term.

Complications Endometrial Ablation Risk Complications

Endometrial ablation complications are associated with an increased risk of postablation pelvic pain and infertility. Of 437 women in a recent study who underwent endometrial ablation, 20.8% reported pain. Interestingly 75% of patients who developed pain reporting it within approximately 2 years of the procedure. For those with pain it unfortunately led to hysterectomy for almost half within the following 2 years to stop the pain.
Other postablation treatments included hormonal therapies. Those most likely to develop postablation pain include those with dysmenorrhea, those who smoke, prior tubal ligation, and were aged less than 40. Although not statistically significant, a diagnosis of endometriosis appears to be related to postablation pain as you would imagine. Adenomyosis and body mass index associations were not statistically significant. A patient with all 4 risk factors for postablation pain (i.e., dysmenorrhea, smoking, prior tubal ligation, and <40 years old) had a 53% chance of experiencing postablation pain.


For women considering this treatment then it is important to be warned of endometrial ablation complications. This includes the risk of pelvic pain at 20.8% more frequently observed in women with preablation dysmenorrhea, tobacco use, prior tubal ligation, age less than 40, and possibly endometriosis. One should consider these preexisting conditions when counselling patients regarding outcome expectations after an endometrial ablation procedure.

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If you have had endometrial risk ablation complications then we are here to help. Get in touch with Dr Victoria Handley today. Don’t suffer in silence. Call FREE on 0800 470 2009 or email

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