An endometrial ablation is a procedure that might be recommended to stop heavy or abnormal vaginal bleeding. But since abnormal bleeding can also be a sign of endometrial cancer, would this put you at higher risk of missing a cancer diagnosis? Or worse, could an ablation put you at an increased risk of developing endometrial cancer years later?

Luckily, early research indicates that you don’t have a higher risk of endometrial cancer post ablation. In this article, we’ll discuss what’s known about links between endometrial ablation and endometrial cancer, as well as what symptoms of endometrial cancer you should look out for.

What Is Endometrial Ablation?

Endometrial ablation is a treatment for heavy or prolonged menstrual bleeding, also known as menorrhagia. During your period (also known as menstruation), blood and mucosal tissue are expelled from the inner lining of the uterus. This inner lining is called the endometrium. An ablation destroys the inner lining of the endometrium, preventing future heavy bleeding. The doctor can do this with a variety of ablation techniques. These involve using heat, cold, microwave, radiofrequency, or electricity to destroy the endometrium.

Endometrial ablation is typically only used when medications don’t help your heavy menstrual bleeding. Because this procedure eliminates part of the lining of the uterus, it’s highly unlikely that you can become pregnant after an ablation.

Before a doctor performs the ablation, they’ll test for any cancer in your uterus. They’ll also look at your uterus through a small camera on a flexible tube. This procedure is called a hysteroscopy. These tests will allow the doctor to diagnose any other problems before completing the ablation.

Scientists have studied possible links between developing endometrial cancer (also known as uterine cancer) and endometrial ablation. Overall, they’ve found that there’s no link.

Here are some questions you may have about ablation and endometrial cancer, and what studies have found on each topic.

Does Ablation Raise the Risk for Endometrial Cancer Later?

Studies on this issue are limited. However, a 2022 study showed that 0 to 1.6 percent of patients who had an ablation got endometrial cancer. This rate is lower than the frequency of endometrial cancer in the general population, which is 3.1 percent. Based on this, it doesn’t appear that ablation raises the risk for cancer. In fact, it may lower the risk.

Can You Miss Abnormal Bleeding as a Warning Sign?

One of the most common symptoms of endometrial cancer is abnormal vaginal bleeding. If you get an endometrial ablation to stop bleeding, you may not bleed if you develop endometrial cancer. There’s concern that missing this early sign could lead to a delay in diagnosis of endometrial cancer.

In one study of people who had endometrial ablation, 74 percent of those who developed endometrial cancer did have abnormal bleeding. This was less than the 90 percent in people who didn’t have ablation, but abnormal bleeding still occurs in most cases of endometrial cancer after ablation.

Another study published in the International Journal of Gynecological Cancer on people who developed endometrial cancer after ablation found that 90 percent of cases were stage 1. Stage 1 cancer is an early stage. It means that the cancer hasn’t spread beyond the uterus. Among the general population, only 75 percent of endometrial cancer is diagnosed as stage 1. These findings indicate that the cancer is found quickly among people who have had ablation, and there isn’t a delay in diagnosis.

Could Scarring Make Cancer Biopsies Difficult?

Adhesions are scar tissue that builds up after an endometrial ablation and can make organs stick together. This may make it difficult to access the uterus. One diagnostic test for endometrial cancer is an endometrial biopsy. This means that a tissue sample is taken from your uterus and sent for cancer testing in the lab. The adhesions could make it difficult to perform a biopsy of the endometrium to diagnose cancer.

Biopsies of the endometrium have sometimes failed due to postablation adhesions. But this is usually not the case. In a 2022 study, 89 percent of people who'd had an ablation were diagnosed with endometrial cancer after successful endometrial sampling. Most of the biopsy samples collected were able to be tested in the lab for cancer without any issues.

This means that if you need an endometrial biopsy after ablation, it’s highly likely that it’ll work. If you do have cancer, your medical team shouldn’t have a problem finding and diagnosing it.

Does Ablation Make Imaging Tests Hard to Read?

There may also be concerns about whether doctors can accurately read transvaginal ultrasounds after ablation. A transvaginal ultrasound tests the thickness of the endometrium. This is a diagnostic tool for endometrial cancer.

Fortunately, a study found that transvaginal ultrasounds can be used after endometrial ablations. Among the people in the study, 71 percent still had a measurable endometrium by ultrasound.

Is Obesity a Shared Risk Factor?

People who tend to need endometrial ablations have some shared risk factors with those who are more likely to develop endometrial cancer. People who have heavy menstrual bleeding are more likely to have a higher body weight. They may also be more likely to have other risk factors for endometrial cancer.

What Symptoms Should You Watch For?

If you’ve had an ablation and are concerned about developing endometrial cancer, it’s important to watch for symptoms that may indicate endometrial cancer. Go to your doctor right away if you notice:

• Vaginal bleeding between periods
• Any vaginal bleeding after menopause
• Pelvic pain or pain in your lower abdomen
• Abnormal (sometimes clear or white) vaginal discharge if you’re postmenopausal
• Heavy or prolonged vaginal bleeding after you’re 40 years old

Working closely with your doctor to understand your endometrial cancer risk is important. Discuss with a healthcare professional whether you might benefit from further testing.

Talk With Others Who Understand

MyEndometrialCancerTeam is a social network for people with endometrial cancer and their loved ones. On MyEndometrialCancerTeam, members come together to ask questions, give advice, and share their stories with others who understand life with endometrial cancer.

Did you get an endometrial ablation? How has it affected your life? Share your thoughts and experiences by commenting below or by posting on your Activities page.