Endometrial ablation recovery timeline: what to expect after the procedure

Endometrial ablation treats heavy periods by removing or destroying the lining of the womb so that it does not regrow each month. The NHS lists it among specialist treatments for heavy periods, offered when treatments from a GP have not worked or a GP thinks another condition may be causing the problem.

Recovery depends partly on how the procedure was done. Some centres perform it as an outpatient procedure with local anaesthetic, which is described in a Manchester University NHS Foundation Trust leaflet, while others use a general anaesthetic, as described in a University Hospital Southampton leaflet. In both, the picture is of a short recovery with a discharge that may continue for several weeks.

Both leaflets describe period-like cramps after the procedure. The Southampton leaflet suggests paracetamol or ibuprofen, taken as directed on the label. The Manchester leaflet says that during the first 24 hours you might have cramping-type pain, nausea or brown discharge, and that the nurse will tell you when you can take further pain relief at home.

After a general anaesthetic, Southampton advises that for 48 hours you may feel sleepier than usual with impaired judgement, so you should not drive, drink alcohol, work, exercise, handle machinery including an oven or hob, or sign legal documents. It encourages gentle walking, such as a 10 to 15 minute walk in the morning and afternoon the day after, and says you can shower the day after the operation, ideally with an adult around in case you feel dizzy.

The Southampton leaflet says you may have some vaginal bleeding for a few days, usually like a light period, which should lessen and become more like a heavy discharge that may be dark in colour, and which can last three to four weeks. It advises using sanitary pads during this time and avoiding tampons because they can increase the risk of infection.

In other words, a discharge lasting several weeks is described as part of recovery. A discharge that turns yellow or green or smells offensive, however, could be a sign of infection and should be reported.

Southampton says that after the operation you will need some time off work to rest and recover, that most women take two to five days off, and that you should speak to your GP if you need longer. Heavy exercise such as the gym or exercise classes should be avoided for at least 48 hours, and swimming until any vaginal discharge has stopped.

It says you can have sex as soon as any vaginal discharge has stopped and you feel comfortable. The Manchester leaflet is more cautious, advising avoiding swimming, baths, sex and tampons for at least two weeks to avoid the risk of infection, though you can shower. The differences reflect local practice, so follow the instructions you are given.

The Southampton leaflet says most women recover well, but as with any operation there can be complications. It advises contacting the unit, your GP or NHS 111 if you have increasing abdominal pain, heavy blood loss (soaking through two pads in an hour), a temperature, abnormal discharge that is yellow, green or offensive-smelling, vomiting and loss of appetite, difficulty passing urine or burning or stinging, or a painful, red, swollen, hot leg or difficulty bearing weight, which may be caused by a deep vein thrombosis.

The Manchester leaflet lists a fever of 38 degrees C or above, worsening pain not improving with pain relief, severe vomiting where you cannot tolerate fluids, shortness of breath, bowel or bladder problems and greenish or offensive vaginal discharge. It describes serious but rare complications including burn injury, perforation of the womb and infection.

The Manchester leaflet says that around 80 to 90% of women experience lighter periods after ablation and that periods may stop for some. That is the trust's own figure and individual results vary, so ask your clinician what to expect for your circumstances.

It stresses that it is not safe to become pregnant after an endometrial ablation, that it can cause severe complications for you and your baby, and that you must always use a reliable form of contraception. Sterilisation can be discussed with your doctor.