Endometrial ablation (diathermy)

Publication date Oct 16, 2007

This information tells you about an operation to remove the lining of your womb using heat. It explains how the operation is done, how it can help, what the risks are and what to expect afterwards.

The benefits and risks described here are based on research studies and may be different in your hospital. You may want to talk about this with the doctors and nurses treating you.

What is endometrial ablation with diathermy?

A hysteroscope is a tiny telescope your surgeon uses to see into your womb. If you have endometrial ablation with diathermy, a surgeon uses a heated wire loop or a rollerball (a ball on the end of a handle) to cut or burn away the lining of your womb. The lining of your womb is known as your endometrium. Ablation means to destroy.

There are lots of ways of removing the lining of the womb. Diathermy means that the heat used to take away the lining comes from an electrical current.

During the operation, the surgeon sees what's happening through a tiny telescope (called a hysteroscope) put inside your womb through your vagina.

Why do I need endometrial ablation with diathermy?

To make your periods lighter: Endometrial ablation is a treatment for heavy periods. Each month, the lining of your womb gets thicker. During your period your womb lining comes away and is passed through your vagina with some blood. You lose about seven to eight teaspoonfuls of blood during a normal period. But during a heavy period you lose twice as much blood or even more.[1] To read more, see our information on heavy periods.

One way of reducing the amount of blood and tissue you lose is to remove the lining of your womb. It's not easy to measure exactly how much blood you lose during your period. But you and your doctor may think about an operation if:[2]

You use more than nine pads or tampons (or both pads and tampons) on your heaviest days
You have to wear both a tampon and a pad
Your period lasts more than six days
You have to get up at night to change your protection
You pass clumps of blood (blood clots)
You stain your bedding or clothes despite wearing tampons and pads
You have 'flooding' (a lot of blood suddenly rushes out)
You stay at home or take time off work during your period.

The heat used in the operation removes about 3 millimetres of the womb lining. This tissue includes a layer of cells that help the lining to grow again each month. Without this layer of cells, the lining doesn't get so thick, so your periods stay lighter.

To make your periods less painful: Some women with heavy periods have a lot of pain each month. This is because the muscles in the womb tighten so they can push out the thick lining. If the lining is thinner, your periods may be less painful.

To improve your life: Heavy periods don't mean there's anything seriously wrong with you. But they can disrupt your life and make you feel miserable. You may stay at home during your period because you are worried you won't get to a toilet in time to change your tampon or pad if you go out. You may feel tired, especially during your period. In studies, women with heavy periods are more likely to be anxious, depressed and have problems with their sex lives than women with normal periods. Bleeding less may improve how you feel about yourself and allow you to get back to normal.

If your heavy periods are making you feel low, you might want to read our information on Depression.

Your doctor will probably suggest this operation only if treatment with drugs hasn't made your periods lighter. Drug treatment is usually tried for at least three months before thinking about surgery.[3] Your doctor may suggest you try a device that releases progesterone into your womb (an intrauterine device, or IUD) to reduce your bleeding rather than opt for surgery straight away. Guidelines for doctors say this should be considered before you start thinking about an operation.[4]

You shouldn't have endometrial ablation with diathermy if:

You want to get pregnant. Pregnancy is possible, but unsafe for both mother and baby after this operation. Your womb lining will be too thin to give the baby the blood supply it needs to grow. There is also a risk that the baby will grow in the tubes that carry eggs from your ovaries to your womb (your fallopian tubes). This is called an ectopic pregnancy. It can be dangerous and the pregnancy has to be terminated.
You want to be certain that your periods will stop. You'll need to have your womb removed (a hysterectomy) to guarantee this.
You have a pelvic infection, cancerous cells in your womb lining or a womb that is large because of big lumps (called fibroids). Women with small fibroids can have this operation.

Heavy periods (also called menorrhagia) are a very common problem. Each year, about 1 in 20 women aged between 30 and 49 see their GP because of heavy periods.[1] Around 16,000 women choose to have endometrial ablation each year. Many of these operations are done using newer techniques, including those that use microwaves. To read more, see our information on Endometrial ablation with microwaves.

There are lots of possible reasons why your periods are heavy. It may be because of a hormone imbalance, or lumps (known as fibroids) in your womb.

What happens during the operation?

Preparing for the operation

A month before the operation, your doctor will probably give you a hormone treatment to thin your womb lining so it's easier to remove it. This may be a single injection of a drug called gonadotrophin-releasing hormone (GnRH) analogue, or a course of danazol tablets.

Before the operation, you'll probably have a general anaesthetic, so you won't be awake or feel any pain during the operation. You'll normally be asleep for 20 minutes to 40 minutes. The actual treatment with the heat may only take four minutes.

The operation

The opening to your womb (your cervix) will be carefully widened so that the operating equipment can fit through. A series of instruments called dilators are put into your cervix, starting with one 2 millimetres wide then replacing it with one 3 millimetres wide and so on until your cervix is open to a width of 9 millimetres (about a third of an inch).
Your surgeon then puts a tiny telescope (hysteroscope) into your womb through your vagina and cervix so he or she can see what's happening during the operation. After this, the heating device is placed inside your womb. The device may be a wire loop or a rollerball. The wire loop is around 6 millimetres long and is attached at an angle to a pencil-shaped handle. The rollerball is a ball about 2 millimetres wide that rotates freely on its handle.
The loop or rollerball is heated using electricity. The surgeon presses on a foot-pedal to switch on the electrical current.
Using a wire loop, the surgeon cuts away slivers of your womb lining. Where your womb lining is thinner, including the corners of your womb, it's usually safer for the surgeon to use the rollerball to burn away the tissue. After cutting away the womb lining with the wire loop, the surgeon may go over the surface with the rollerball. The blood becomes sticky (coagulates) and seals up the blood vessels.
Fluid is continuously pumped into your womb during the operation to keep it swollen. This helps the surgeon to see inside your womb, and also washes out blood and tissue during the operation. A close check is kept on how much fluid goes into your womb and how much washes out.

Surgery that uses the wire loop to cut away (or resect) the womb lining is called transcervical endometrial resection. Surgery that uses the heated rollerball to burn away the tissue is called rollerball ablation. A combination of the two is often used, but the rollerball is sometimes used on its own.

You don't need to have any stitches or dressings.

How can this operation help me?

Periods are lighter for around 8 in 10 women who have their womb lining removed.[5]And periods stop completely for over a third of women.[5]

About three-quarters of women are satisfied after endometrial ablation using diathermy.[5] In one study, 8 in 10 women said they would recommend the treatment to their best friend.[6]

After rollerball ablation to remove their womb lining, women in one study said they had improvements in:[7]

Pelvic pain (pain in the tummy and back): Nearly three-quarters of the women said they had less pain.
Premenstrual symptoms: Over two-thirds of the women had fewer symptoms, such as bloating and feeling irritable, before their period.
Their sex life: Almost all the women said their sex life got better after the operation.
Ability to do usual activities: All women could return to normal work. More than 8 in 10 found it easier doing the housework.

But endometrial ablation doesn't work for everyone. Up to a quarter of women who have this operation still have heavy periods. The operation seems to work less well in women under the age of 40.

What are the risks?

All operations have risks. Your surgeon should tell you about the risks with this operation before you have it. Anaesthetics can have side effects. For example, you may feel sick afterwards. It is also possible, but rare, to have an allergic reaction to the anaesthetic. It's important to tell the doctor if you have any allergies. Your blood pressure, heartbeat, body temperature and breathing will be closely monitored during the operation.

It's difficult to say for sure how likely you are to have a problem during or after surgery. There hasn't been much research on endometrial ablation. But serious problems seem to be rare.

Problems that can happen straight away

In the largest study on ways to remove the womb lining, involving over 10,000 women, about 1 in 30 women had problems from the operation (complications).[8] [9]

Tears (perforations) in the womb or cervix. The heated instrument may burn or pierce through the womb.
Very heavy bleeding. You may bleed heavily during the operation or afterwards (doctors call this haemorrhage).
Haematoma. If you bleed during the operation, blood can build up under the skin and cause a solid swollen lump. This lump may go down by itself or you may need surgery to drain off the blood.
Infection. As with all operations there's a risk that you will get an infection. Antibiotics can treat this.
Absorbing too much fluid. The surgeon will stop the operation if you've absorbed more than 1,500 millilitres of the fluid into your bloodstream, because this can make you ill.
Injury to the bowel. The bowel is close to the womb and can stick to it. So it may be burned by the heated instrument in the womb.[5]

About 1 in 100 women need emergency surgery during their operation to correct a problem. About half of these operations are to remove the womb (a hysterectomy). Others need to have a hole in their womb repaired.[8]

Problems that may happen later

Heavy periods can come back. About 1 in 4 women need another operation within five years of having their womb lining removed because the lining has regrown and their periods have become heavy again. If this happens, you can have the same type of operation or a hysterectomy.[10] More than 1 in 10 women have a hysterectomy within two years of having endometrial ablation.[11]

If you've been sterilised before you have rollerball ablation, you're more likely to suffer pain in your pelvis and need a hysterectomy. This is known as postablation tubal sterilisation syndrome. Between 1 in 20 and 2 in 20 women who have rollerball ablation after being sterilised have this problem.[12] [13]

Using a rollerball to remove the womb lining may cause fewer problems than using a heated wire loop (transcervical endometrial resection).[8] For example, the chances that the surgeon will damage blood vessels are slightly smaller with rollerball ablation, so you're less likely to bleed heavily during the operation.

A study involving over 10,000 women found that using the two techniques together was safer than surgery using the heated wire loop on its own. The same study found that 2 out of the 10,000 women died because of problems with their operation.[8]

Is the operation painful?

You won't feel any pain during the operation, but you may be sore for a few days afterwards. Painkillers (such as paracetamol or ibruprofen) can help.

If you do get a lot of pain after surgery, it's important to tell the nurse or your doctor. You may have an infection. Or there may be damage to your womb or other organs nearby.

What will happen if I choose not to have this operation?

Heavy periods are not usually harmful. But they can disrupt your life.

You may need to take time off work or miss social events when you have your period.
You may not feel confident about playing sport or going swimming.
If your periods are very heavy, you may prefer to stay at home so that you can get to the bathroom quickly.
Losing a lot of blood can make you feel tired and weak because your body doesn't have enough red blood cells. Doctors call this condition anaemia. You may need a treatment, such as iron tablets, to help you make more red blood cells.

It's difficult to say what will happen to your periods if you don't do anything about them. Sometimes periods are heavy for only a short time. For example, they may be heavy just after a girl starts her periods or in the year or so before the menopause.

If you're approaching the menopause, you may not want to do anything about your heavy bleeding because you know your periods will stop soon.

What other treatments are there?

Drugs: Many women try drug treatments first. A drug called tranexamic acid (known by its brand name, Cyklokapron) works best. About 6 in 10 women who take tranexamic acid have lighter periods.[14] It works better than nonsteroidal anti-inflammatory drugs, such as mefenamic acid (brand name Ponstan), and better than some treatments that affect the level of hormones in your body. But nonsteroidal anti-inflammatory drugs also help with period pain. If you get both pain and heavy bleeding, you may be better off taking one of these drugs.

About a third of women who take tranexamic acid feel queasy and get leg cramps.[14]

Women in studies say that surgery to remove their womb lining works better than drug treatment for heavy bleeding. After two years, women who choose surgery had lighter periods and fewer heavy bleeding days. After two years, 6 in 10 women taking drugs had gone on to have surgery.[15]

A device that releases progesterone: These are known as intrauterine devices (or IUDs for short). 'Intrauterine' means the device sits inside your uterus, which is another name for your womb. It is also a contraceptive, so it may be worth considering if you don't want to get pregnant. IUDs for heavy periods have a hormone called progestogen in them. Progestogen is a man-made (synthetic) version of the natural hormone progesterone. IUDs release a set amount of the hormone into your womb each day to stop the lining becoming thick.

The National Institute for Health and Clinical Excellence (NICE), the government body that decides which treatments should be available on the NHS, says that having an IUD fitted is the first treatment women with heavy periods should consider.[4]

Women who use an IUD called Mirena that releases a progestogen, called levonorgestrel, find it reduces bleeding by over 75 percent.[16] One study found that two-thirds of women who were due to have a hysterectomy cancelled their operation after six months of using this type of IUD because they were so pleased with the results.[17] But another study found that 2 in 5 women who have an IUD still need to have a hysterectomy within five years.[18]

An operation to remove the womb lining works better than having an IUD fitted. But one study showed that after one year, women were just as happy with the results whichever treatment they had.[15] About half the women who have an IUD fitted say they get side effects, such as feeling bloated, tenderness and putting on weight.[17]

Other older types of surgery to remove the womb lining: Diathermy is an older type of operation to remove the womb lining. There are other techniques that use heat from a laser beam or a special vaporising electrode instead of a heated rollerball or wire to burn away the lining. Doctors need to 'see' inside your womb using a tiny telescope (hysteroscope) for this kind of operation. The older types of operation all work as well as each other.[5]

Newer types of surgery to remove the womb lining: There are newer ways to remove the lining of your womb. These include using heated water-filled balloons, heated salt water and other electrical currents or microwaves. The surgeon doesn't need to 'see' inside your womb for this kind of operation.

The National Institute for Health and Clinical Excellence, which advises the government on health care, says women who need endometrial ablation should be offered one of these newer operations. But it also says the older type, using a hysteroscope, may be a better choice for some women.[4]

Newer types of operation work as well as diathermy at helping heavy periods, although it's slightly more likely that your periods will stop with a hysteroscope operation. But the newer ways have a few advantages:[5]

You may recover faster
You're more likely to need only a local anaesthetic instead of a general anaesthetic (local anaesthetics have fewer risks)
The operation is quicker and easier.

Some research suggests that newer techniques may be safer. For example, the risk of bleeding may be lower, even though the surgeon can't see what is happening in the womb during the operation.[19] [20] But more research is needed to be certain. Older techniques like diathermy are harder to do and need very experienced and highly trained surgeons to do them.

To learn more about a newer technique that uses microwaves instead of heat, see Endometrial ablation with microwaves.

There is also an operation that uses cold temperatures to freeze and destroy the lining of your womb.[21] It is called endometrial cryotherapy. There haven't been many good-quality studies on endometrial cryotherapy, but the research shows it probably works as well as endometrial ablation (which uses heat). Almost 9 in 10 women have lighter periods after endometrial cryotherapy.[21] Between 2 in 10 and 3 in 10 women who have endometrial cryotherapy find that their periods stop altogether.[21]

Hysterectomy: An operation to remove your whole womb is the only way to guarantee that you'll have no more bleeding. This surgery works better than just having the lining of your womb removed.[9] [14] [22] But a hysterectomy is a serious operation and there are more risks. You'll need to spend more time in hospital. And it takes much longer to recover and return to your normal routine than it does with diathermy. You should be able to get back to your normal activities within two to three weeks after having your womb lining removed. But it can take up to eight weeks to recover after a hysterectomy.[9] Guidelines for doctors say you should only be offered a hysterectomy if other treatments haven't worked, you want to be completely free of periods, and you have specifically asked your doctor for it.[4]

To learn more about this operation, see our information on hysterectomy.

What can I expect after the operation?

It takes a few hours to recover after a general anaesthetic, but you should be able to go home the same day. People rarely have to stay in hospital overnight for this type of operation.

For the rest of the day you'll need to stay at home and take it easy. You may have some cramps (like bad period pains) but these should be gone by the next day. Painkillers, such as ibuprofen or paracetamol, should help. Your doctor may also give you antibiotics to stop you getting an infection.

You will get a watery discharge for about 10 to 14 days. This discharge may be a bit blood-stained at first.

You should be able to drive the next day and be back at work within two or three days. You might want to wait to have sex until the watery discharge has stopped. If you are having hormone replacement therapy, you can continue to take it after this operation.

There will be some scarring inside your womb, but you'll only be able to see it on a scan. The electrical current used in this operation is set at a low level so it can't burn any deeper than 6 millimetres. This stops the wall of the womb being damaged.

It's harder to get pregnant after your womb lining has been taken out, but it does sometimes happen. You should use your normal contraception unless you've had an X-ray to confirm that you're no longer able to have a baby. Some women find that their periods stop altogether after this operation.

References

Vessey MP, Villard-Mackintosh L, McPherson K, et al. The epidemiology of hysterectomy: findings in a large cohort study. British Journal of Obstetrics and Gynaecology. 1992; 99: 402-407.
Coulter A, Peto V, Jenkinson C. Quality of life and patient satisfaction following treatment for menorrhagia. Family Practice. 1994; 11: 394-401.
Royal College of Obstetricians and Gynaecologists. The initial management of menorrhagia: Evidence-Based Guidelines No. 1. RCOG Press, London, UK; 1998.
National Institute for Health and Clinical Evidence. Heavy menstrual bleeding. January 2007. Clinical guideline CG044. Available at http://www.nice.org.uk/CG44 (accessed on 11 October 2007).
Lethaby A, Hickey M. Endometrial destruction techniques for heavy menstrual bleeding (Cochrane review). In: The Cochrane Library, Issue 3, 2006. Wiley, Chichester, UK.
Boujida VH, Philipsen T, Pelle J, et al. Five-year follow-up of endometrial ablation: endometrial coagulation versus endometrial resection. Obstetrics and Gynecology. 2002; 99: 988-992.
el Senoun GS, Mousa HA, Mahmood TA. Medium-term follow-up of women with menorrhagia treated by rollerball endometrial ablation. Acta Obstetricia et Gynecologica Scandinavica. 2000; 79: 879-883.
Overton C, Hargreaves J, Maresh M. A national survey of the complications of endometrial destruction for menstrual disorders: the MISTLETOE study. British Journal of Obstetrics and Gynaecology. 1997; 104: 1351-1359.
Lethaby A, Shepperd S, Cooke I, et al. Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding (Cochrane review). In: The Cochrane Library, Issue 3, 2006. Wiley, Chichester, UK.
Cooper KG, Jack SA, Parkin DE, et al. Five-year follow up of women randomised to medical management or transcervical resection of the endometrium for heavy menstrual loss: clinical and quality of life outcomes. BJOG: an International Journal of Obstetrics and Gynaecology. 2001; 108: 1222-1228.
Bain C, Cooper KG, Parkin DE. Microwave endometrial ablation versus endometrial resection: a randomized controlled trial. Obstetrics and Gynecology. 2002; 99: 983-987.
McCausland AM, McCausland VM. Frequency of symptomatic cornual hematometra and postablation tubal sterilization syndrome after total rollerball endometrial ablation: a 10-year follow-up. American Journal of Obstetrics & Gynecology. 2002; 186: 1274-1280, discussion 1280-1283.
Mall A, Shirk G, Van Voorhis BJ. Previous tubal ligation is a risk factor for hysterectomy after rollerball endometrial ablation. Obstetrics & Gynecology. 2002; 100: 659-664.
Working Party for Guidelines for the Management of Heavy Menstrual Bleeding. An evidence-based guideline for the management of heavy menstrual bleeding. New Zealand Medical Journal. 1999; 112: 174-177.
Marjoribanks J, Lethaby A, Farquhar C. Surgery versus medical therapy for heavy menstrual bleeding (Cochrane review). In: The Cochrane Library, Issue 3, 2006. Wiley, Chichester, UK.
Stewart A, Cummins C, Gold L, et al. The effectiveness of the levonorgestrel-releasing intrauterine system in menorrhagia: a systematic review. BJOG: an International Journal of Obstetrics and Gynaecology. 2001; 108: 74-86.
Lethaby AE, Cooke I, Rees M. Progesterone/progestogen releasing intrauterine systems for heavy menstrual bleeding (Cochrane review). In: The Cochrane Library, Issue 3, 2006. Wiley, Chichester, UK.
Hurskainen R, Teperi J, Rissanen P, et al. Clinical outcomes and costs with the levonorgestrel-releasing intrauterine system or hysterectomy for treatment of menorrhagia: randomized trial 5-year follow-up. Journal of the American Medical Association. 2004; 291: 1456-1463.
Pellicano M, Guida M, Acunzo G, et al. Hysteroscopic transcervical endometrial resection versus thermal destruction for menorrhagia: a prospective randomized trial on satisfaction rate. American Journal of Obstetrics & Gynecology. 2002; 187: 545-550.
Parkin DE. Microwave endometrial ablation: a safe technique? Complication data from a prospective series of 1400 cases. Gynaecological Endoscopy. 2000; 9: 385-388.
National Institute for Health and Clinical Excellence. Endometrial cryotherapy for menorrhagia. March 2006. NICE interventional procedure guidance 157. Available at http://www.nice.org.uk/ipg157 (accessed on 11 October 2007).
Zupi E, Zullo F, Marconi D, et al. Hysteroscopic endometrial resection versus laparoscopic supracervical hysterectomy for menorrhagia: a prospective randomized trial. American Journal of Obstetrics and Gynecology. 2003; 188: 7-12.

Glossary

menstrual cycle: The menstrual cycle is the regular monthly process that causes an egg to be released from the ovaries so that a woman can get pregnant. The menstrual cycle causes her period, the bleeding that happens if she does not get pregnant.
progesterone: Progesterone is a hormone that plays a part in a woman's menstrual cycle and in pregnancy. A form of this hormone made in the laboratory, called progestogen, is often added to contraceptive pills and hormone replacement therapy (HRT).
intrauterine device (IUD): An intrauterine device (IUD) is a type of contraceptive. It is a small device made of copper or plastic, with threads at the end. These threads can be left in your vagina while the rest of the device sits in your womb (cervix). IUDs stop eggs sticking to your womb and growing.
fallopian tubes: Fallopian tubes are the two tubes that come out of the top of a woman's womb. They carry eggs from the to the womb.
ectopic pregnancy: An ectopic pregnancy is when a fertilised egg lodges itself outside of the womb, usually in the fallopian tube. This can be a dangerous condition.
fibroid: A fibroid is a lump of extra tissue that can build up in the wall of the womb. Sometimes it can grow big enough to feel. It can cause pain and bleeding, and make it difficult for a fertilised egg to take hold in your womb. If these problems become too bad, you can have fibroids removed by surgery.
hormones: Hormones are chemicals that are made in certain parts of the body. They travel through the bloodstream and have an effect on other parts of the body. For example, the female sex hormone is made in a woman's ovaries. Oestrogen has many different effects on a woman's body. For example, it makes the breasts grow at puberty and helps control periods. It is also needed to get pregnant.
general anaesthetic: You may have a type of medicine called a general anaesthetic when you have surgery. It is given to make you unconscious so you don't feel pain when you have surgery.
cervix: The cervix is a piece of tissue that sits between a woman's womb and her vagina. It has a small opening in it that gets much bigger when a woman is having a baby.
allergic reaction: You have an allergic reaction when your overreacts to a substance that is normally harmless. You can be allergic to particles in the air you are breathing, like pollen (which causes hay fever) or to chemicals on your skin, like detergents (which can cause a rash). People can also have an allergic reaction to drugs, like penicillin.
blood pressure: Blood pressure is the amount of force exerted by the blood on the walls of the vessels that carry it. You can think of it like the water pressure in your home: the more pressure you have, the faster and more forcefully the water flows out of the shower. Blood pressure is measured in millimetres of mercury (written as mm Hg). When your blood pressure is taken, the measurement is given as two numbers, for example 120/80 mm Hg. The first, higher, number is called the systolic pressure, and the second, lower, number is the diastolic pressure. The systolic number is the highest pressure that occurs while the heart is pushing blood into the arteries. The diastolic number is the lowest pressure that happens when the heart is relaxing and is not pushing the blood.
body temperature: Just like the temperature outside, your body temperature is a measure of how warm you are. If you have a higher temperature than normal, it can mean that your body has an infection or you have a . Women also have a higher temperature at the time of month when their release an egg ().
haemorrhage: Haemorrhage is a word doctors use for bleeding. Any time blood escapes from a vessel, it's called a haemorrhage.
hysterectomy: A hysterectomy is an operation to take out a woman's womb (also called her uterus). Sometimes the ovaries and fallopian tubes are removed as well.
pelvis: Your pelvis is the area between your hips.
infection: You get an infection when an organism, such as a bacterium, a fungus or a virus gets into a part of your body where it shouldn't be. For example, an infection in your nose and airways causes the common cold. An infection in your skin can cause rashes such as athlete's foot. The organisms that cause infections are so tiny that you can't see them without a microscope.
red blood cells: Red blood cells are the part of your blood that makes it red. Their main job is to carry oxygen from your heart and lungs to the tissues of your body. Once these cells unload oxygen, they pick up carbon dioxide. They take carbon dioxide back to your lungs so it can be breathed out of your body.
anaemia: Anaemia is caused by having too few red blood cells. People with anaemia look pale and get tired easily, among other things.
menopause: When a woman stops having periods, it is called the menopause. This usually happens around the age of 50.
NSAIDs: NSAID stands for nonsteroidal anti-inflammatory drug. NSAIDs help with pain, inflammation and fever. They are called 'nonsteroidal' because they don't contain any steroids. Aspirin and ibuprofen are both NSAIDs.
local anaesthetic: A local anaesthetic is a painkiller that's used to numb one part of your body. You usually get local anaesthetics as injections.
antibiotics: These medicines are used to help the fight infection. There are a number of different types of antibiotics that work in different ways to get rid of bacteria, parasites and other infectious agents. Antibiotics do not work against viruses.
hormone replacement therapy: Hormone replacement therapy (also called HRT) is given to women after the menopause to replace the oestrogen (the main female hormone) that is no longer made by their ovaries. It can be given either as oestrogen alone or as a combination of oestrogen and progesterone (another female hormone). It is useful to treat menopausal symptoms such as hot flushes, and to prevent brittle bone disease (osteoporosis). But there are concerns that it may increase the risk of breast cancer, heart attacks and strokes.
X-ray: X-rays are pictures taken of the inside of your body. They are made by passing small amounts of radiation through your body and then onto film.

This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

Endometrial ablation (diathermy)

What is endometrial ablation with diathermy?

Why do I need endometrial ablation with diathermy?