Heavy menstruation is unlikely after endometrial ablation. That said, the goal of the procedure is to stop, shorten, or lessen your menstrual flow — not put a stop to your overall menstrual cycle.
Most people experience light vaginal bleeding or spotting the first 1–3 days following surgery, according to Dr. Jill Purdie, a board certified OB-GYN and medical director at Pediatrix Medical Group in Atlanta, Georgia.
You might also notice an uptick in clear vaginal discharge over the next 2–3 weeks. Discharge may be thin, watery, or tinged with blood, but it shouldn’t smell any different than usual.
If you notice a huge change from your usual scent or catch a fishy, foul, or pungent waft, consult with your healthcare professional, as this could be a sign of infection, explains Elizabeth Swenson, MD, OB-GYN, at Wisp, a telehealth platform focused on sexual and reproductive health.
Some people notice a change to — or a disappearance of — their menstrual period immediately following the procedure, says Swenson.
Other people will need to wait up to 3 months for their menstrual cycle to settle into a “new normal.”
For these folks, “the first period after the ablation period may be similar in bleeding volume and length as before surgery,” explains Purdie. “But by the second or third period, these individuals should notice a change.”
Once the body has healed, most people will see a reduction in the amount of bleeding they have during their periods, she says.
The effects are most likely to be permanent for people who are perimenopausal or within 5 or so years of their periods naturally stopping, explains Aldene Zeno, MD, OB-GYN, founder of Essence Health and Urogynecology in Glendale, CA.
“People who are farther out from menopause, like in their 30s and early 40s, may notice their bleeding return to something heavier 1–2 years after the procedure,” she says.
Indeed, a 2019 study identified younger age as one of several factors that may increase the risk of failure and surgical re-intervention within 2 years after endometrial ablation.
Other factors include:
- painful menstruation (dysmenorrhea)
- menstrual bleeding that lasts longer than 7 days at a time (menorrhagia)
- 5 or more pregnancies carried to 20 weeks of gestational age or later (parity)
- cesarean delivery
Research cited by
- younger than age 45
- parity of 5 or more
- tubal sterilization
They observed that endometrial ablation failure commonly occurred in people with:
- endometrial tissue growing into the muscular wall of the uterus (adenomyosis)
- benign growths inside the uterine muscles (intramural fibroids)
- an accumulation of blood in the uterus (hematometra)
“In rare cases, the return of the heavy bleeding may be related to something precancerous or even cancerous,” says Zeno.
“While spotting after the procedure is common, heavy bleeding is not,” says Zeno. “Anyone soaking through a menstrual pad in under 2 hours should seek medical attention.”
You should also seek immediate medical care if you experience symptoms of infection or other complications, says Swenson.
- fishy or foul-smelling discharge
- severe or worsening pain
- difficulty urinating or passing bowel movements
If you’re still spotting 2–3 weeks after the procedure, consult with your surgeon.
Heavy vaginal bleeding immediately following the procedure can be a sign of severe complications, so it’s important to seek immediate medical attention.
For many people, menstrual flow will lessen or disappear within 3 months of the endometrial ablation. Some people find that their period disappears entirely within 12 months.
Certain factors can increase the likelihood of your pre-operative menstrual flow or an otherwise heavy period returning years later.
Your healthcare professional can answer any questions you may have about your individual risk. They can also discuss your overall expectations for menstrual relief and recommend additional or alternative treatment options.
Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.