What is endometrial ablation?

Endometrial Ablation is the permanent destruction of the inner lining of the uterus (the endometrium) as a way to treat heavy periods. This is done when child bearing is complete and other treatments have been unsuccessful. The procedure is most often able to be performed in the office without the use of sedation. The primary goal of an endometrial ablation is reduction in the heaviness and length of periods. Some women even experience cessation of periods altogether (amenorrhea)

What to Expect


First, you’ll schedule an evaluation. This will determine if an endometrial ablation is the right procedure for you. The following steps will happen during the evaluation:

  • You’ll take a pregnancy test. If you are pregnant, you will not be a candidate for an endometrial ablation.
  • We’ll potentially do a biopsy to look for abnormal cells in your uterus.
  • We’ll discuss what medication you’re taking. Some medications have the potential to cause problems during the procedure. We will discuss all of your options during this time.

Next, we’ll discuss the plan for your procedure. Day-of preparation includes:

  • Planning for someone to pick you up.
  • Depending on the type of endometrial ablation, we may prescribe medication for you to take that will thin your uterus lining.
The Procedure

An endometrial ablation may be done in the office or in the operating room. Just like during your routine pelvic exams, you’ll lie on an exam table. In most cases, we numb your pelvic area and give you sedatives to make the procedure more comfortable.

During the procedure, Dr. Poppen will insert a delicate, wand-like device into your vagina. This device extends through your cervix and into your uterus, where it can access the lining. Depending on the type of endometrial ablation, the device sends energy, heat, or cold to destroy part of the uterus lining. The device turns healthy tissue into scar tissue and is designed to be precise so that only a safe portion of the uterus lining actually gets destroyed. We use the latest technology to make the procedure is completed safely with minimal discomfort.


Generally, it takes 2-3 days for patients to carry on with their normal routine post-procedure. You’ll see the results from the procedure take effect within 2-3 months. At this time, you’ll notice that your periods are lighter or you may stop having periods altogether.

Commonly Asked Questions

Endometrial ablation is a common procedure that effectively stops heavy bleeding. See below for answers to some commonly asked questions.

Individuals who benefit from an endometrial ablation experience very heavy or long periods. They may also experience abnormal uterine bleeding or bleeding between periods. In serious cases, the bleeding can be so heavy that it affects daily activities and causes a low blood count (anemia).

Periods are considered heavy if they:

  • Cause you to be anemic because you lose a lot of blood every month
  • Last more than 7 days
  • Interfere with your ability to do normal activities

After the procedure, your periods will be lighter or you may no longer have a period. Monitor how heavy your periods are and how regularly they occur.

The ideal candidate has extremely heavy periods that are unable to be relieved by medications. Additionally, candidates are sure they don’t want to get pregnant and are willing to have a tubal ligation (tubes tied), are with a partner who has a vasectomy, or are willing to use some form of daily birth control.

Additionally, candidates will need to make sure heavy periods are not caused by cancer, thyroid disease, or other health issues.

Endometrial ablation won’t make you gain or lose weight.

We do not recommend getting pregnant after an endometrial ablation. It is dangerous for both you and the baby.

It is possible to get pregnant after the procedure. You’ll still ovulate (put out eggs) and will have some remaining uterus lining, which means that an egg can implant and be fertilized.

Following endometrial ablation, you have a higher chance of a miscarriage or dangerous complications during pregnancy.

It is very important to use birth control after the procedure. We recommend considering getting sterilized (tubal ligation) when you have an endometrial ablation.

Not everyone is a candidate for endometrial ablation. Generally, you shouldn’t have an endometrial ablation if:

  • Your bleeding is managed by other methods
  • You or your partner are not sterilized (tubal ligation or vasectomy) or you are not willing to use birth control after the procedure
  • You are post-menopausal
  • Your uterus is an abnormal shape

People who have experienced menopause or are at a high-risk for developing endometrial cancer shouldn’t have this procedure. After menopause, the risks for developing endometrial cancer increase. Destroying endometrial tissue in this procedure makes it harder to find cancer cells in the uterus. The risk of missing cancer cells outweighs the benefits of lighter periods.

Additionally, some people with fibroids or who’ve had certain surgeries on their uterus are not able to have an endometrial ablation.

Endometrial ablation is a common procedure that effectively stops heavy bleeding without having to take medicine every day. Because the procedure does destroy tissue there are risks to be aware of, including:

  • Heavy bleeding
  • An allergic reactions
  • Puncturing the uterus
  • Harming organs near the uterus

Mara™ Water Vapor Ablation

What are heavy periods?

Heavy periods, also known as menorrhagia, are very common and can cause enough bleeding to soak through your sanitary napkins every hour for several hours in a row. About one-third of women seek treatment for heavy periods.¹

What are the symptoms?

While every period is different, common symptoms of heavy periods include:

  • Needing to double the number of sanitary products for your protection
  • Bleeding longer than seven days
  • Needing to change your sanitary protection during the night
  • Passing large blood clots in your flow
  • Soaking through sanitary protection every hour for several hours in a row

Heavy periods can make it difficult to work, exercise, and be socially and sexually active. You may also feel weak or tired and have no energy. The signs of heavy periods are most likely to start between the ages of 30 and 40.

What is Mara?

The Mara™ Water Vapor Ablation System provides an endometrial ablation treatment that uses natural water vapor to reduce your heavy periods. This two-minute* treatment can be performed conveniently in your doctor’s office without incisions or the need for general anesthesia.


of women had bleeding reduced by ≥ 50%³

Consistent positive menstrual status “moderate bleeding or less” continued to be seen three years after the Mara treatment.²

How does Mara work?

Mara uses natural water vapor to gently treat the lining of the uterus, which is the source of heavy menstrual bleeding in women who have not reached menopause. When treated, it may no longer re-grow to cause heavy monthly bleeding. Mara is only for women who no longer want to become pregnant in the future.

The water vapor treatment takes 2 minutes, as part of a 4-minute total procedure.

The Mara Water Vapor Ablation System is indicated to ablate the endometrial lining of the uterus in premenopausal women with menorrhagia due to benign causes for whom childbearing is complete.

How will Mara impact my life?

Women experienced significant improvement in quality of life and satisfaction after treatment with Mara.²


experienced improvement in quality of life³^


had an improvement
in their sex life†


said their cramping


would recommend Mara
to a friend

* The water vapor treatment takes 2 minutes, as part of a 4-minute procedure.
^ Based on patient-reported Menorrhagia Impact Questionnaire (MIQ) scores.
† of women whose periods affected their sex life.
‡ of women who experienced menstrual cramping before Mara.


1. The American College of Obstetricians and Gynecologists. FAQ June 2016.
2. Mara Water Vapor Ablation System Instructions For Use.
3. Levie MD, Chudnoff SG. A Prospective, Multicenter, Pivotal Trial to Evaluate the Safety
and Effectiveness of the AEGEA Vapor Endometrial Ablation System.
J Minim Invas Gynecol. May/June 2019; 26(4); 679-87.