ETA on 27 November 2020: This post still stands as a good representation of my experience post-ablation. This has proved to be my most popular ever blog post. I regularly get comments from people anxious about this operation, and I hope my blog helps you. Do remember it only records my experience, and while I’m a doctor, I’m not a medical doctor! Three years on, my periods have virtually ceased. I do have some perimenopausal symptoms and while I’m just about the age they might start (late 30s), I do wonder if this procedure kickstarted them early (see below about that). But for me, being free of the pain and exhaustion of heavy bleeding is still worth it. Your mileage may vary!
It’s now been five months since I had an endometrial ablation. I thought I would write a few thoughts about it for anyone who might be considering having this operation, since it’s surprisingly hard to find useful personal accounts of this procedure online. While this is a different sort of content for this blog, since reproductive health is a feminist issue and because I frequently argue the personal is political, it seems pretty on brand!
As many of you know, I’ve had almost lifelong issues with my periods – I started menstruating fourth months shy of my twelfth birthday (so that’s 24 years ago this month! Next year I should have a quarter-century party perhaps?!) and by the time I was twelve I was taking a regular prescription painkiller during my period. (Sidenote: these painkillers are probably what gave me a hiatus hernia, which ended up causing me agonising pain as an undergrad; long-term use of NSAIDs can do massive damage to your digestive system. However I carried on taking this painkiller – though I tried to reduce my usage as much as possible – but none of the other options I tried had the same effect. Hurrah!) When I was sixteen I went on the pill for the first time – not for contraceptive reasons (it would be a long time before that was relevant!) but to control my periods. That helped a little, but I suffered quite a few side effects that never went away, so I ditched them after six months or so. At university I tried another pill; again after six months I dropped them because of side effects more aggravating than painful periods – and suffered a massive breakthrough bleed that I had to take a coagulant to stop, which freaked me out enough I didn’t try a hormonal contraceptive for several years. (Another sidenote: when I went crying to the GP about this bleeding – it really freaked 20-year-old me out! – I was told not to be hysterical. I was also told my periods would improve when I had a baby. Definitely on the cards then…!) I took a bunch of different supplements and changed my diet to see it it had an impact – no dice. In the meantime I had lots of different tests. At one point I was diagnosed with PCOS, and then that diagnosis was rescinded. I certainly suffered from luteal cysts that often caused extreme pain during ovulation, too. I had several uterine polyps removed under general anaesthetic. Then I had a Mirena put in, which stopped the polyps returning but made me put on about 20lbs in a few weeks, and ended up needing to be surgically removed because it got stuck in my cervix.
I’m not detailing all this personal medical history to make anyone uncomfortable or to overshare, but just to give readers (particularly those who don’t menstruate) an idea of just how many options the average person with problem periods may try. Anyway, not long after I had the Mirena out, Kieran and I decided we were open to the idea of conceiving. We assumed it might take a long time because of my problems so when I got knocked up pretty quickly it was quite a lovely surprise!
Three months after our daughter was born, my periods came back. On Halloween. Yes, really! The universe has a horrible sense of humour. This was despite the fact I was breastfeeding around the clock and had many friends whose periods hadn’t returned for a year or more after birth. I’m not ashamed to admit I cried. How was I going to cope with a baby and my periods? Maybe they would be better now, I thought hopefully.
Reader, they were not. I bled and bled and bled, often in agony. I gave it lots of time to get better, because hormones after pregnancy are whack. But when my baby was ten months old I went on a combined contraceptive pill as by this point I wasn’t worried about my milk supply dropping. I had researched the pill very carefully and it paid off – virtually no side effects, much lighter and less painful periods. I might take two or three prescription pills the whole period. That was great!
Then I had a pulmonary embolism probably caused by taking the pill. Whoops!
As you can see, I had come to the end of the line on medical options by this point. As we’d decided to have only one child, it was an easy decision (though not an unemotional one) to go for an endometrial ablation. This is only an option if you do not want to conceive again, as it’s unlikely you could carry a pregnancy to term and it would probably be dangerous to do so. Luckily, my GP was very happy to refer me and my surgeon was very happy to do it. This isn’t always the case for women who want fertility-ceasing treatments, where there is a lot of policing of our reproductive bodies and institutional anxiety about whether we will regret becoming functionally infertile.
There are several methods of endometrial ablation. I had radiofrequency, which I believe is the most commonly used. At my hospital, ablation is done under general anaesthetic. From everything I’ve read, unless you are at high risk under general, don’t go for a local! That numbs your cervix but you can feel what is going on inside you and by all accounts that’s not a good time. The actual operation takes only a few minutes and you should, even after a general, be able to go home the next day.
When I came around I thought – okay, this is going to be hard for a couple of weeks, as my pain levels were very high. I was given several boosters of morphine over the first few hours I was on the recovery ward and then in my room. So I was very pleased that my surgeon wrote me a script for codeine, as the NHS guidelines suggest taking paracetamol afterward, which I knew would do absolutely nothing! But in fact my recovery was much less painful than anticipated. I had virtually no bleeding, which I think is a sign my surgeon had done a very tidy job cleaning up inside, and I only needed the heavy duty painkillers for a day or two. I was signed off work for two weeks, which I took because I was exhausted, but I wouldn’t be surprised if a lot of people only need a week. However, do not plan to have less than this. My hospital recommended a week minimum, and I’d ignore the online advice of only 2-5 days off unless you absolutely can’t afford to.
But here’s what you really want to know: how are my periods now? Well, I’m still quite cautious talking about the status quo, as sometimes the effects of ablation reverse over time. Still, five months on, I am very glad I had it done. My periods did not stop altogether, unfortunately, but they are so light that I hardly notice them. During my last period I did not take a single painkiller. Not even basic ibuprofen! I’ve gone from having to lie on a towel at night because of leakage to having a pad in the morning that is barely stained.
A word of caution: the only side effect I’ve noticed, but it has impacted on me, is that I’ve developed acne on my cheeks. Cheek acne is a good indicator of hormonal change (although of course environmental factors can’t be ruled out). Changing hormone levels is not something any online guide to ablation ever mentions, and my surgeon certainly never mentioned it. I have only found one clinical study which talks about it. But this peer-reviewed study makes it clear that ablation seems to have almost as much of an impact on FSH levels as simple hysterectomy (when womb and cervix are removed but ovaries etc are left intact). That is, both procedures cause FSH level to rise, which indicates impaired ovarian function. Now, this study seems to neglect a number of other factors – endometrial ablation is most commonly performed in women who are at an age where they may be entering perimenopause, for instance – but nonetheless, the data seems to be to be convincing:
Compared to the preoperative level, 6 weeks, 6 months and 1 year after surgery, a significant rise in serum FSH was found in the hysterectomy group, as well as in the ablation group … An unexpected the finding was the equal rise of FSH level after the operation in both hysterectomized and ablated patients. A paracrine effect of the endometrium on the ovarium function, as seen in rabbits is often suggested, but never scientifically substantiated in humans. On the other hand, one can speculate, that also after endometrial ablation in some way the uterine and thereby the ovarian bloodflow is reduced, resulting in an `acute effect’, described by Stone. To proof a relationship of uterine surgery and a rise of the FSH levels, participation of a control group without uterine surgery should be appropriate.
So far as my searches have thrown up there doesn’t seem to have been much work done on this issue after this 1998(!) study, which as you can see in the quotation above raises a good many unanswered questions about the relationship between uterine and ovarian functions. (If any of my science buds know differently, please chime in.) I am not surprised by this, because in my experience if your reproductive system isn’t actively killing you then it’s hard to get the medical industry interested – particularly if you can’t be easily fobbed off with one pill or another. Of course there are exceptions to this, as my current GP for instance shows! But in my experience, if you aren’t able to do both your own research and self-advocacy, suggesting treatments to your medical providers and pushing for specialist care, you aren’t likely to get any help. This is very frustrating, since I know many people who don’t have the advantages I do – experience doing research, ability to access articles behind paywalls (see above) – and who end up suffering because no one will talk to them frankly about what the literature actually says and help them work out the best options for them as an individual, instead of offering a one-size-fits-all cure. Rising FSH levels are only seen as a cause of concern for women who want to conceive, but they can cause all sorts of perimenopausal/menopausal symptoms and so should be handled with more care than they seem to be in this case.
Anyway. I have really spotty cheeks right now and they make me feel pretty self-conscious. But I’m on a new skin care regimen (probably a good idea as I age, anyway!) and there’s always make up. For me, the price is worth having less pain, less mess, and much less exhaustion every month. I hope I continue to barely notice my periods until it’s time for them to stop altogether!
Thanks for posting this. I’m so sorry you’ve had such a rough time – but heartily agree that it’s an important feminist activity to talk about reproductive health.
Thank you! TBH it’s been so much a part of my life that rather than a rough time it’s been the status quo – but it really shouldn’t have to be. Reproductive health problems don’t necessarily have simple solutions, but there shouldn’t be so many roadblocks in our way toward finding those solutions!! I think it takes an average of ten years for endometriosis to be diagnosed, for instance. So much medical gatekeeping.
Thank you for posting this. I shared it on my FB and already 1 person has said she also had one, another didn’t even know it was an option and the first person is willing to connect with them to talk about their experience, a 3rd person has now said they had a different procedure (a resection) and is also willing to talk about it.
This is why I love social media. Thank you for risking the overshare. You are already making a difference to other women.
Thanks so much for letting me know this! That is good to read.
Thanks for sharing. This post was very informative and I enjoyed learning about it.
Thanks for reading!
Thanks for writing this. The wall of silence around women’s reproductive health is formidable. I didn’t have the level of difficulties you did, but wish I’d had the confidence to push for answers at an earlier age than I did. Just understanding what is ‘normal’ and what isn’t is difficult when you’re young and uninformed. All the very best to you and your family going forward.
Very much agree. And thank you!
OMG Yes, Rachel. Thank you for sharing. It took me WAY too long to get to the ablation, and I went through way too many doctors who seemed to know little to nothing about women’s reproductive health. My GP at the outset prescribed an anti-depressant…because I seemed to need help “coping” with what she considered “menstruation.” She had NO RESPONSE AT ALL to the bleeding itself. I use a menstrual cup, so I knew it was half a pint a day or more for months without stopping…. but this seemed to mean nothing to her. It was the specialist who took one look at my history and rushed me in for an ablation. BEST DAY EVER! I was just too far gone psychologically to endure something under local anesthesia and so the general anesthesia was essential. Here in the States we are rushed out of the hospital and so I was discharged just two hours after the procedure and went back to work three days later. I could have used a slower recovery, but the pain was minimal, and the bleeding was simply gone, forever. It was life-changing. To all of those looking for narratives of the ablation (as I was before mine)…it was virtually painless, and recovery was easy. I did not take any painkiller. I have no interest in using this endometrium for babies so I had no qualms about the end of my chances of bearing children. If I were young like you Rachel, it might have been harder psychologically, but for me, it was fantastic and I recommend it to everyone. Now I can take long train rides, attend weekend workshops, go camping with my family. Next week I’m driving to Toronto (4 straight hours!)…and I will see you there Rachel!
See you soon!! We can discuss life without womb linings 😁
Thanks (I’m booked in in a few weeks).
I have adenomyosis
unfortunately for me didn’t work,i had Nova Sure done in November 28 and
spotting little in Dec and Jan , but in in February bamm….the period was back with spotting and clothing lasting 12 days , in March nothing but in April 26 back again and spotting over a week after turning bright red bleeding and clots for 4 days messy for 18 days altogether .stopped for a week and now spotting again . Am 50 now and thinking on hysterectomy bcs i cant bearing this anymore . Pls let me know how you feel now . The 3 th month have to show what you can expect in the future .
I’m sorry you feel awful, Edith! It seems for some people the procedure doesn’t take. I am still mostly period free a year and a half later, but I think around 10% of cases the ablation doesn’t work. I hope you can find a way to be more comfortable.
I’m wondering if you had irregular spotting after. I had my ablation in September. There are times when I wipe that there is a little pink and then times when there’s a little blood in the toilet. All of this is much better than having a period. However, it’s inconsistent but also has been consistently more frequently.
I did for a month or two but not since. I hear it’s quite common though!
I’m glad the ablation worked for you. Your story is my story but worse. My period started when I was 11 or 12. I bled so heavy right away that in the 7 th grade I had to wear a towel because I bled through everything. I was told after having kids it would get better the pain would ease up. That never happened 2 kids later. In 2008 I decided to get the ablation which stop my period for 3 months. I continued to heavy periods until I was pregnant in 2012. Who would have thought? I found out when I was 6 weeks and I was in complete denial. The dr said everything looked good baby looks good but there wasn’t much research with pregnancy after an ablation an I wasn’t about to a test dummy. So I decided to have abortion Nevsky I was terrified. The pain the heavy periods the super plus tampons plus a pad continued until I decided to take pills to help stop the bleeding. That didn’t work. I’ve had two IUD’s epic failure. So I tried another ablation October 2018 . Sad to say March 11,2019 I had a full three day period. No tampons but regular pads. It’s march 28 th and I’m in pain and bleeding again. I’m so disappointed sad and becoming depressed at this point. Again I’m glad it worked out for you. I have no clue what to do next except have an hysterectomy and I never wanted to do that. I’m 44 and miserable 😭
Hi Rachel 😊
Great blog! Just had the same ablation done and praying my 3 week periods are a thing of the past. I too have had a flare up of acne but can’t find anything about it. Good to know I’m not alone but I hope yours has cleared up now 😊
Thank you so much Rachele and Vickie!!! I have my Ablation scheduled this morning and I feel so much better about it after reading both of your experiences. It’s scary, but exciting!! Thank you again!!
Ive been waiting for this over 1 year and this morning the hospital called arrangements made for next week . Totally panicking needed a review and im glad ive across this .
Thank you so much Rachel and Vickie!!! I have my Ablation scheduled this morning and I feel so much better about it after reading both of your experiences. It’s scary, but exciting!! Thank you again!!
I am considering this procedure and was relieved to read your personal account. I am premenopausal and for the past year have been dealing with periods that last up to a month at a time. Trying to do my research and weight my options.
I am curious. Did you have nausea as a side effect? I have read that nausea is a common.
Thanks for the post…. I just got my ablation done and was looking for review and it gives me immense relief… thanks a ton… take care always
I probably didn’t have any nausea… mine was fine under general anesthesia… I believe if u dnt take any solid food 6 hours prior to and no fluid intake before 2-3 hours of the procedure you will not have nausea… just little giddy as the aftermath of the General Anesthesia… it’s going to be 12 hrs post procedure for me now and I haven’t had any pain or contractions until now… finger crossed!!
Take care n stay blessed!!!
They gave me a patch behind my ear for nausea. I had my procedure this morning. I feel great, so it must have worked. I am have almost no bleeding. Is that normal?
Try this group. https://www.facebook.com/groups/264368540364822/?ref=group_header
Rachel thank you for your post. Just back from gyno now and the pamphlet is not as informative.. 48 heavy bleeding for almost a year gonna try meds first then this but it’s a relief to hear from someone who’s had it done… 😁😁😁
I had an ablation in March (almost June now) periods have been lighter but not by much tbh also I have a constant flow of muddy discharge or thick brown gravy type I’ve been told there is no infection and that it’s my body just adjusting but if I’m honest I feel in limbo before I could deal with incontenant pads on my epic periods but I would also have a free week or two without bleeding etc I’m 39 had two kids and single and tbh the way my body is now I doubt I’ll ever be able to get into a relationship let alone physical one it’s getting me down and I feel the drs have just brushed me off AGAIN (had to fight to be noticed and diagnosed with adenmyosis) if anyone had any tips for dealing for life after this be great personally I regret ever having it done now 😦
I am glad that you are now pain free and it has been successful for you. I too had endometrial-ablation. You can read about my experience via my link.
There is one very useful facebook group that provides you with information about endometrial ablation. They say they are not a cheerleading group for endometrial ablation but rather provide you with information that you never were told by your gynecologist or the colorful pamphlets in your doctor’s office or any advertisements you have seen on facebook or elsewhere. Basically, this group states as do some gynecologists that ablation is a temporary fix at best and most women will need a hysterectomy within 5 years. Also mentioned is that there are side effects to endometrial ablation and that your hormones are affected even though your gynecologist and literature may say otherwise. This is the best one stop shopping place for information regarding endometrial ablation and it has informed me tremendously. Maybe this group might be of help to you. NovaSure & Other Endometrial Ablation Procedures Info & Support.https://www.facebook.com/groups/264368540364822/?ref=group_header
Thanks so much for sharing. I had an ablation 1 week ago today. Anybody have bloating? Is am seriously bloated and curios if it’s normal. Thanks !!
Wow! Thank you so much for sharing. I’m considering getting this done as I have had the exact experiences/condition you have had and have tried all the other options as well! You have answered many questions and I’m glad it is working well for you.
It’s amazing so many women suffer from our periods and there is very little out there to help us or inform us if we are making the right decision to go forward with an ablation.
Often doctors do prescribe the quick fix solutions with out knowing or researching the post long term effects of these quick fix solutions. And unfortunately some female doctors can loose empathy. Many times I’ve had the eyes roll 🙄 when I come for my appointment of feeling exhausted and heavy periods. And I only see a doctor as it’s a last resort and I’m totally not coping with it at all. My decisions not to have the pill and mirena a due to side effects just seem to annoy them.
I’m glad you have posted this, more women should talk about this. We all know there are many women going through the same thing and we are obviously hunting for any information out there. We need more women to write about there experiences to help us make the right decisions for our bodies.
I am booked to do the procedure next month and this is so helpful to hear about other experiences. I hope this is the right decision and will post more about it. My only concern is, not lasting forever, and eventually I have to do hysterectomy.
Good luck! I still have virtually no periods after more than 3 years so fingers crossed it’s a long term solution for you and me!
Just happened upon your story and its like we are identical body twin with everything you have gone through. I’m 4 children later and had ablation yesterday in the hope of some bit of normality. Have you found anymore research on possible links between menopause/ablation I’m hoping not 😀 want a tiny bit of normality for a while before more raging 😀