If you've lived a lifetime of heavy periods, endometrial ablation is a minimally invasive gynecological procedure that may help to alleviate at least some of your monthly burden. Endometrial ablation is typically recommended for women who experience excessively heavy periods that interfere with their daily lives, and it involves removing or destroying the endometrium, or the lining of the uterus. 

If you're considering an endometrial ablation, you might have (very valid) questions about how it could affect your sex life. Read on to learn more about how endometrial ablation is performed, what to know post-op, and how the procedure can impact your future sexual experiences. 

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How is endometrial ablation performed?

Endometrial ablation is considered a less invasive alternative to a hysterectomy because it doesn't require incisions and can often be completed under conscious sedation. During this procedure, your healthcare provider will use a thin scope to look inside the uterus and pass a tool through it to destroy the lining. This can be performed using various techniques, including heated fluids, microwave energy, electric current, or freezing. The choice of technique often depends on the specific characteristics of your uterus and your doctor's expertise. The good news is that endometrial ablation is usually done as an outpatient procedure, meaning you can typically go home the same day.

It's important to note that endometrial ablation is generally recommended for women who have completed their families, as pregnancy after the procedure can be risky. While it doesn't remove the uterus, it does alter its lining, which can make it difficult or dangerous to carry a pregnancy to term.

Resuming intimacy after endometrial ablation

After undergoing endometrial ablation, most women will experience a recovery period of a few days to a couple of weeks. During this time, it's common to have some cramping, watery or bloody discharge, and frequent urination.

Your healthcare provider will give you specific instructions about activities to avoid during recovery, including sexual intercourse, but you should generally wait at least two weeks before having sex. This will give your cervix time to heal and can help prevent pain, infection, and other complications. Rushing into penetrative intimacy can also be painful and may increase your overall recovery time. 

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Many women worry about pain during intercourse, changes in sensation, or whether they'll be able to enjoy penetrative sex as much as they did before the procedure, all of which are valid concerns. However, once your doctor gives you the green light two to three weeks later, you can usually resume sexual activities. 

When you do start engaging in penetrative sex again, you might be surprised to experience positive changes. Some women report increased comfort and enjoyment during sex after endometrial ablation, particularly if they previously experienced pain or discomfort due to heavy bleeding. The reduction or elimination of menstrual bleeding can also lead to greater spontaneity and confidence in intimate situations.  

Potential challenges and how to address them

On the other hand, some people do face challenges returning to sex post-endometrial ablation. These can include vaginal dryness, temporary loss of sensation, or anxiety about engaging in penetrative intimacy. It's important to remember that these issues are often temporary and can be addressed with patience, communication, and (sometimes) additional medical support.

If you experience vaginal dryness, don't hesitate to use lubricants. Water-based lubricants are generally safe and can significantly enhance comfort during intercourse. If dryness persists, talk to your doctor about other options, such as vaginal moisturizers or low-dose vaginal estrogen.

If you find yourself feeling anxious about resuming sexual activities after the procedure, know that this is entirely normal. Take things slow, communicate openly with your partner about your concerns, and don't hesitate to seek support from a therapist or counselor specializing in sexual health if needed.

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The importance of advocating for yourself

Open and honest communication is key when it comes to navigating your sex life after endometrial ablation. Don't shy away from asking your OB/GYN or gynecological surgeon questions about what to expect or sharing any concerns you have about intimacy post-procedure.

With your partner, be open about your feelings, any physical changes you're experiencing, and what feels good or uncomfortable. This can help foster understanding and ensure that both of you are on the same page when it comes to resuming and enjoying your intimate time together.

If heavy menstrual bleeding has negatively impacted your life for far too long, endometrial ablation can be a life-changing option. At the same time, everyone's journey following the procedure is unique. While you may notice some changes in your sex life after-the-fact, you may just might find that things feel largely the same as before. The key is to be patient with yourself, listen to your body, and celebrate all of the positives that come with reduced bleeding during that time of the month. 


Kristyn Hodgdon is the Co-Founder and Chief Creative Officer at Rescripted

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