Concierge gynaecology · UK
Endometrial ablation for heavy periods, the NICE way.
A day-case procedure for heavy menstrual bleeding that has outlived medical therapy — done properly, on the NICE NG88 pathway, by a consultant gynaecologist. Mirena first if you haven’t tried it, hysteroscopy and biopsy before, ablation only when it is genuinely the right step.
Why patients choose us
- 01
A consultant gynaecologist, in a proper theatre
Not a rushed outpatient slot with the wrong kit. A named consultant, the second-generation device that fits your cavity, and the anaesthetic you chose.
- 02
The NICE pathway, honestly walked
Mirena IUS first if you haven’t tried it. Hysteroscopy and endometrial biopsy first to rule out anything sinister. Ablation only when it is genuinely the right step.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private endometrial ablation costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
Outpatient ablation in our network: £2,400–£3,800, home the same day.
| Procedure | Indicative range | Typical duration | Recovery / results |
|---|---|---|---|
| Endometrial ablation (outpatient, LA + oral) | £2,400–£3,800 | 15–20 min | Same visit |
| Endometrial ablation (day-case, GA) | £3,800–£6,500 | Half-day | Same visit |
| Hysteroscopy + endometrial biopsy (standalone) | £900–£1,800 | 15 min | 7–10 days path |
| Hysteroscopy + biopsy + ablation combined | £3,200–£6,800 | 30–40 min | Same visit |
| Mirena IUS fitting (first-line for HMB) | £450–£850 | 15 min | Same visit |
| Consultant gynaecology consultation | £250–£450 | 30 min | Same visit |
Prices vary by clinic, by which gynaecologist does the case, by the device used, and by whether a hysteroscopy and biopsy are combined with the ablation on the day. We come back with a firm quote within one working day.
The problem
Skip the Mirena chat, skip the biopsy, and you skip the safeguards.
Endometrial ablation is one of the most rushed private gynaecology bookings in the UK — offered before Mirena, before hysteroscopy, before biopsy. We do it in the NICE order, or not at all.
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Not sure it is the right step?
Mirena IUS is first-line for a reason. We say so before you book an ablation, and offer that if you haven’t tried it.
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Worried about the pain?
Outpatient with local and oral analgesia, or day-case under GA — you pick, informed by an anaesthetist, not booked in blind.
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Want it done properly?
A named consultant gynaecologist, a proper theatre, second-generation devices, and a biopsy result before the treatment is called complete.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to review — hysteroscopy, biopsy, ablation, and the honest advice on contraception afterwards.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. How heavy, how long, what you have already tried — pill, tranexamic acid, Mirena — and how it is affecting your life.
- 02
Before
We come back with a recommendation
Within one working day: whether ablation is the right next step, whether a hysteroscopy and biopsy are needed first, and an indicative price.
- 03
Before
We arrange hysteroscopy + biopsy
Ablation is only offered after the cavity has been checked and the endometrium sampled to exclude hyperplasia or cancer. Often the same visit as the ablation.
- 04
On the day
Arrival at the clinic
Consent, a chat with the gynaecologist and anaesthetist. Outpatient with local plus oral analgesia, or day-case under general anaesthetic — your call.
- 05
On the day
The ablation itself
Three to five minutes of active treatment inside a 15–20 minute procedure. NovaSure bipolar radiofrequency is the UK gold standard; balloon, microwave or cryo devices are used where they fit better.
- 06
On the day
Home the same day
A short recovery with cramping and a light pad. Home within a few hours. With GA you will need someone to collect you.
- 07
After
Recovery, review and contraception
Watery discharge for two to four weeks, periods settle over three to six months. Contraception is non-negotiable — pregnancy after ablation is dangerous.
Typical end-to-end: 2–3 weeks from enquiry to procedure. Bleeding pattern settles over 3–6 months.
When it helps
When endometrial ablation is the right step.
The situations we see most, plus the one red flag that means investigation before anything else.
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Heavy menstrual bleeding (HMB)
Periods heavy enough to soak through pads or tampons hourly, pass clots, or force you to plan life around your cycle.
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Failed medical therapy
Tranexamic acid, the pill, Mirena IUS have been tried and either did not work, were not tolerated, or are not wanted.
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Iron-deficiency anaemia from bleeding
Persistently low ferritin and haemoglobin driven by menstrual loss, often needing iron infusions.
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Completed family, wanting to keep the uterus
You do not want more children but would rather avoid hysterectomy — ablation sits neatly between the two.
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Small submucosal fibroids or polyps
Focal lesions can be resected hysteroscopically at the same visit — larger fibroids distorting the cavity need a different plan.
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Wanting lighter periods, not surgery
For the right patient, ablation gives 80–90% a significantly lighter bleed with none of the recovery of a hysterectomy.
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Perimenopausal HMB
Heavy bleeding in the run-up to menopause — ablation often bridges you across without needing hysterectomy.
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Red flag: postmenopausal bleeding
Any bleeding after menopause, or unexplained intermenstrual bleeding, must be investigated urgently before any ablation is considered.
Procedure options
One name, several devices — and several ways to have it done.
What each device on the table actually involves, and which fits which cavity — plus the outpatient vs day-case choice.
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NovaSure bipolar radiofrequency
The UK gold standard. Three-dimensional mesh device delivers controlled bipolar RF energy in about 90 seconds. Suits most regular cavities.
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Thermachoice / Cavaterm balloon
A hot-fluid balloon conforms to the cavity and thermally ablates the lining. A reliable option where cavity shape suits.
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Microwave endometrial ablation
A microwave probe applied across the cavity. Well-suited to slightly irregular cavities that a rigid device cannot match.
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Cryoablation
A freezing probe kills the lining under ultrasound guidance. Less commonly used in the UK but valuable in selected cases.
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First-generation resection / rollerball
Older hysteroscopic technique using distension fluid and electrical loops. Now rare in the UK — kept for very specific anatomy.
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Outpatient (LA + oral analgesia)
No fasting, no GA. Local anaesthetic block, ibuprofen and paracetamol, and home within an hour. Not everyone tolerates it — you get to choose.
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Day-case under general anaesthetic
Asleep with a consultant anaesthetist. Preferred if you are anxious, have a narrow cervix, or want no awareness at all.
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Consultation only
An honest discussion of whether ablation, Mirena, or hysterectomy is the right step — no obligation to book.
Our vetted UK network
A small panel of gynaecologists, we picked them.
Consultant gynaecologists with a subspecialty interest in HMB. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every gynaecologist in our network.
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Consultant gynaecologists with a subspecialty interest in HMB
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Hysteroscopy and endometrial biopsy always performed before ablation
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Second-generation devices (NovaSure, balloon, microwave) available
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Outpatient and day-case GA options offered — never one-size-fits-all
Safety and recovery
What to expect afterwards — honestly.
Endometrial ablation is a common, safe day-case procedure — but it is not sterilisation, and it comes with real numbers on outcomes and further intervention you should know before you decide.
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Contraception is mandatory afterwards
Ablation is not sterilisation. Pregnancy after ablation is dangerous — placenta accreta, miscarriage and preterm birth are all more likely. Contraception continues until menopause.
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~80–90% report much lighter periods
Around a third stop bleeding altogether (amenorrhoea). Most of the rest get a significantly lighter, more manageable cycle.
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~15% need further intervention within 5 years
Either a repeat ablation or a hysterectomy. It is a real number and worth knowing before you choose.
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Hysteroscopy + biopsy first, always
The cavity is inspected and the endometrium sampled to exclude hyperplasia or cancer. Ablating an untested cavity is not acceptable practice.
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Not suitable with large cavity fibroids
Fibroids over about 3 cm that distort the cavity need a different approach — myomectomy or hysteroscopic resection first, or a different treatment altogether.
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Previous classical caesarean is a caution
A thin uterine wall from an old classical CS raises the perforation risk. Not an absolute bar, but the anatomy dictates the plan.
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Uncommon but real risks
Uterine perforation (0.3–1%), fluid overload with resection techniques, thermal injury to bowel or bladder (rare), and endometritis. The team is set up for all of them.
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New bleeding after ablation deserves urgent review
An ablated cavity is harder to sample later, so endometrial cancer can be harder to detect. Any postmenopausal bleeding, or new bleeding after a settled result, needs urgent investigation.
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Red flags
Heavy fresh bleeding, fever, spreading pelvic pain or foul-smelling discharge after the procedure — call the clinic or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever device was used, the note the gynaecologist sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note and the biopsy result before your review, just ask.
- 01 Header
Indication and device chosen
Why the procedure was done — HMB with failed medical therapy, completed family — and which second-generation device was used.
- 02 Technique
Hysteroscopy, biopsy and ablation
Cavity length and appearance at hysteroscopy, biopsy site, distension media used, energy delivered and treatment time.
- 03 Findings
Cavity, endometrium and biopsy result
Any fibroids, polyps or scarring found, and the histology of the endometrial biopsy — the sample must come back before you can call the treatment complete.
- 04 Impression
Recovery, contraception, review
Read this first: expected recovery, the non-negotiable contraception advice, and when to come back if the bleeding does not settle.
Recognised by major UK insurers
Cover for endometrial ablation varies by insurer — usually funded when medically indicated for HMB with failed medical therapy. We confirm cover before booking.
Frequently asked
Everything we get asked about endometrial ablation.
Quick answers on Mirena vs ablation, contraception afterwards, outcomes, and what to do if the bleeding comes back.
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Who is endometrial ablation actually for?
Women with heavy menstrual bleeding (HMB) that has not responded to medical therapy — typically tranexamic acid, the combined pill or, most importantly, the Mirena IUS — who have completed their family and want to keep the uterus rather than proceed to hysterectomy. NICE NG88 sets this pathway out clearly.
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Is ablation a contraceptive?
No. This is the single most important thing to understand. Ablation destroys the endometrial lining but the uterus is still there and pregnancy is still possible. Pregnancy after ablation is dangerous — with a much higher risk of placenta accreta, miscarriage and preterm birth — so effective contraception is mandatory until menopause.
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Do I have to try the Mirena coil first?
NICE puts the Mirena IUS as first-line medical treatment for HMB because it works very well for most women and can be reversed. If you have already tried it and it did not suit you, or if you have decided against it after an honest discussion, ablation is a reasonable next step.
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Outpatient with local anaesthetic, or day-case under general?
Both are offered. Outpatient with a paracervical block and oral analgesia works well for many women and lets you drive home. Day-case GA suits anxious patients, narrow or scarred cervices, and anyone who simply does not want to be aware. Neither is medically superior.
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How well does it work?
Around 80–90% of women report a significantly lighter bleed. Roughly a third stop bleeding altogether. About 15% will need further intervention — either a repeat ablation or a hysterectomy — within five years, and that is worth knowing in advance.
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What about fibroids?
Small submucosal fibroids or polyps can be resected hysteroscopically at the same visit. Larger fibroids (over about 3 cm) that distort the uterine cavity make ablation unreliable — you would usually need a myomectomy, hysteroscopic resection or a different plan first.
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What happens to my periods afterwards?
A watery, sometimes bloody discharge for two to four weeks is normal. Periods settle over three to six months into whatever the new pattern will be — usually much lighter, sometimes absent altogether.
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Is any bleeding after ablation something to worry about?
Yes, if it is new or unexpected. Because the cavity has been treated, an endometrial cancer developing later is harder to detect on biopsy or scan. Any postmenopausal bleeding, or new bleeding after a period of stability, needs urgent gynaecology review.
Related
Looking for something else?
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Menopause
Symptoms, HRT and the perimenopausal transition.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more -
Mirena IUS fitting
First-line for HMB — quick, reversible, effective.
Learn more -
Contraception
Options after ablation — because pregnancy is still possible.
Learn more
Nearby in the library