About six weeks ago, I had a uterine ablation. Although I knew the procedure itself went well immediately afterwards, I wanted to wait and see it had the desired effect before writing about it. Has it reduced or eliminated the awful heavy bleeding- the flooding- I’d been suffering with for years? I wrote about this in some detail after I had a hysteroscopy investigation. back in February, But in summary, I was bleeding very heavily for 10 days out of 24 and consequently feeling tired, unattractive and thoroughly miserable. I’d tried the progesterone-only pill, the Mirena coil and Transexamic acid and nothing helped. The hysteroscopy and associated uterine biopsies confirmed that there was nothing abnormal or sinister. As a consequence, my gynaecologist recommended uterine ablation.

What Is Uterine Ablation?

Uterine ablation, (or endometrial ablation), is the surgical destruction of the lining tissues of the uterus. It’s a treatment for abnormal but benign uterine bleeding, (menorrhagia). It’s by no means as serious or as major as a hysterectomy.

There are several ways of carrying out the ablation, including with laser or electricity and by freezing or heating. It’s a quick procedure and the post-op recovery is 1-2 weeks.

I had NovaSure ablation.  There are no incisions and it leaves the uterus intact. It’s carried out vaginally and requires general anaesthetic.

1. The surgeon opens the cervix and inserts a slender wand. He/she inserts a triangular-shaped netted device into the uterus through this wand.
2. The netting expands to fit the size and shape of the uterus.
3. Precisely measured radio-frequency energy is delivered through the netting for about 90 seconds. This destroys the lining of the uterus.
4. The netted device is pulled back into the wand, and both are removed from the uterus.

Before The Op

I went to the hospital for 1pm. My treatment was under the NHS, so I was pleasantly surprised to have a room with a bed and an en-suite bathroom. I had to undress and put a gown and paper knickers on. Within the first hour there, a nurse carried out routine pre-op assessments including blood pressure, pulse, oxygen saturation and height and weight, (for the anaesthetic), and measured my legs for surgical stockings. The anaesthetist and the gynaecologist (surgeon) came to ensure I understood what was going to happen and to answer any questions. And finally, another nurse inserted a vaginal pessary. This is a progesterone based product to soften and widen the cervix to make the procedure easier. This took a matter of seconds to insert and wasn’t uncomfortable in the slightest.

It was almost 5pm when I went down to theatre. I was absolutely starving because I hadn’t eaten since 7am and the last drink I’d had was water at 11am. It was a very hot day and the room was boiling, so I was very ready to go. I was a little apprehensive but overall, I was looking forward to getting it over and done with. I hugged and kissed Ian goodbye, (he’d been with me throughout), and walked to the operating room.

The Uterine Ablation

I’d never had a general anaesthetic before, so didn’t know what to expect. I was very calm and relaxed though and everything went blurred within seconds.

The next thing I knew, I was in a recovery ward and a nurse was chatting to me. I kept drifting in and out of sleep and I truly felt like I wanted to sleep forever. When I came around a bit more, I was weepy, but that was no surprise; I’m always emotional. I was relieved to be alive I think! I felt light-headed and a little nauseous, especially when the nurse was asking me about food, (we realised we were both keen cooks), and I had painful cramps. In fact, they were contractions. The anaesthetist gave me some intravenous anti-inflammatory medication and some codeine which I took orally in tablet form. The nurse brought a heat pack for my tummy and wheeled me and my bed,  back to my room. Ian was waiting for me and it was wonderful when I heard him say hi.

The Immediate Aftermath

I was tearful and in pain from the contractions for about an hour. I gave birth to both of my children with only Entonox, (gas and air), so I consider myself to be very tolerant to pain. The contractions were because of the vaginal pessaries that I’d had previously. I’d say they were equivalent in strength to those during mid-labour; I had to breathe through each one. They eased off though, although they didn’t stop completely until the middle of the night. I have to be honest and say that I felt truly awful for the hour or two immediately after my uterine ablation. I felt sick, dizzy and hot and I was desperate to take the surgical stockings off!  However, I was pleasantly surprised because I anticipated a lot of bleeding and there was barely any.

The nurses checked my blood pressure and pulse half-hourly and told me that I could go home once I’d passed water. They need to see the first wee, so it was all the indignity of using a bed pan, albeit in the bathroom. Ian saw everything that day- I’m glad he doesn’t have a squeamish disposition!  I managed to eat some toast, which meant we could go home. I was light-headed and felt faint when I walked to the car, but I knew I was ok.

We got home just before 10pm, so it felt like a long day. Poppy and Harry were waiting for me and they got drinks for us and gave me a very welcome hug. Ian had kept them and my family updated throughout the day and in turn, Poppy had let my friends know. I got washed and changed, took some co-codamol, prescribed by the hospital and went to sleep.

The First Few Days After Uterine Ablation

The following morning I was tired. My tummy and lower back ached and I just felt very slow. I slept during the morning and got up after a shower. There was minimal blood-stained discharge, but nothing more. The contractions had stopped completely. I ate and drank normally during the day. Ian cooked and did everything else, but I was absolutely fine to sit at the table and walk up and down stairs. I kept up with the prescribed ibuprofen and co-codamol and had an early night.

The day after that, (36-48 hours post-op), I felt much better. My hips ached, but I think that’s because of the position I’d been in during the uterine ablation. I still felt a little slow and fuzzy-headed but my parents came and took Ian and I out for lunch. Again, I ate and drank normally and even had a couple of glasses of wine. I was ready for yet another early night but I felt fine in general.

I was tired for about 10 days afterwards. By that I mean I slept more deeply and for longer in the morning. As well as that, I felt more tired despite doing a lot less than normal. I needed to sit down more often. I found it hard to concentrate or focus for the first week so did very little work. There was an occasional ache and pain in my hips, legs and lower back but no tummy aches after the first few days. And no bleeding.

Six Weeks After Uterine Ablation: Has It Worked?

The timing of the procedure means that I’ve had two cycles since then. As expected, I had my usual pre-menstrual symptoms because ablation doesn’t affect the hormonal control of the cycle. (I don’t get PMT per se, but I do get breast tenderness and sometimes feel a little more emotional).

Both times, I’ve had very light bleeding that lasted for about three days followed by a day or two of discharge. Truly minimal loss.  There has been no flooding or clotting. Physically, I’ve had mild stomach cramps and a slight headache but this is incomparable to the symptoms I had before. I still get frequent lower backache but I’d say it’s less painful and less often. This I suspect, is a separate issue. There has been no need to get up and change my bedding, (which I often had to do two or three times per night), so I’m less tired from that alone. I haven’t had the light-headedness that I assume was caused by the extreme blood loss. My energy levels are back to where they should be.

Emotionally, I no longer feel unattractive and undesirable. I can rest easy and no longer worry about flooding when I get out of the car, or stand up after dinner, or go to the gym. I don’t need to avoid wearing light clothing or fear sitting down on someone’s sofa.

My uterine ablation has been a total success and I’m delighted. I wish I could have had it done years ago, but I’m so thankful that we have the wonderful NHS and that everyone I saw from start to finish was excellent. I feel happy, healthy, strong and full of energy. What more could I ask for?

And Finally…

***{Added later: I have written an update blog post about my uterine ablation nine months on which you can read here}