Austin Women's Health Center Blog&Inspiration

Ablation vs. Hysterectomy: Which is Right For You?

March 12, 2024
ablation vs hysterectomy

Let’s look at the difference between hysterectomy and ablation to help you understand the differences and potentially prepare for the procedure. Hysterectomy is the surgical removal of the uterus vs. an ablation, which is a less invasive medical procedure that removes the uterine lining permanently.


A hysterectomy is the surgical removal of the uterus. If you and your doctor decide that a hysterectomy is the best choice for you, there are different kinds of hysterectomies, depending on the reason for the procedure.

Hysterectomies are the second most common surgery for women of reproductive age in the US. Like any procedure, hysterectomies come with some risks, but they are generally safe with great success rates and can lead to a better quality of life. After a hysterectomy, you’ll no longer have a period or be able to get pregnant.

An abdominal hysterectomy removes the uterus through an incision in the abdomen.

A vaginal hysterectomy is the removal of the uterus through the vagina. This method is often preferred because the lack of a large abdominal incision can shorten recovery time.

Why would I need a hysterectomy?

There are a lot of different reasons that people with uteruses elect to have a hysterectomy performed, including:

– excessive or abnormal menstrual bleeding

– painful menstruation

– fibroids, or non-cancerous uterine growths that cause abnormal bleeding and discomfort

– uterine prolapse, which causes weakening muscles and ligaments to no longer support the uterus

– gynecological cancers, including ovarian, cervical, or uterine precancer or cancer, or to avoid getting cancer, especially for those who are at high risk

– chronic pelvic pain due to endometriosis and/or scarring involving the uterus

– adenomyosis, or thickening of the uterus

– gender affirmation surgery for transgender, nonbinary, or gender-diverse individuals

When someone has their cervix and uterus removed, it is called a total hysterectomy. In addition, a provider may elect for the removal of the fallopian tubes and ovaries, depending on the medical cause of the procedure. In both types of hysterectomy, sometimes the cervix is left behind, called a partial or supracervical hysterectomy.

What are the different types of hysterectomy?

A hysterectomy can be minimally invasive, depending on the technique used.

Vaginal or hysteroscopic hysterectomy

In a vaginal hysterectomy, the uterus and other reproductive organs are removed through the vagina, which eliminates the need for a large abdominal opening and speeds recovery time.

Abdominal hysterectomy

In this type of procedure, a surgeon removes the uterus through an incision in the abdomen.

Laparoscopic or robotic hysterectomy

A laparoscope is a thin instrument that contains a camera to help see the internal organs. A surgeon inserts the laparoscope through a small incision in the abdomen as they remove the uterus through small incisions in the abdomen or vagina.

Laparoscopically-assisted vaginal hysterectomy

The uterus is removed through the vagina, but additionally, a few small incisions are made in the abdomen for a laparoscope to help remove the uterus and other organs.

What happens during a hysterectomy?

During a hysterectomy, you will usually be under a general anesthetic. The procedure generally lasts 1-4 hours. Once a vaginal procedure has begun, the doctor might decide to perform an abdominal hysterectomy instead of a vaginal hysterectomy. A common reason for this is if the doctor discovers lots of scar tissue in the abdomen, which can be caused by multiple past cesarean sections, which makes the organs too difficult to remove through the vagina.

What is the expected hysterectomy recovery like?

After any hysterectomy, you will usually need to stay in the hospital for at least one night. The complete recovery time is usually 3-4 weeks for a vaginal hysterectomy, compared to 6 weeks or more for an abdominal hysterectomy.

RELATED: Do I Have Endometriosis Quiz

After a hysterectomy, it’s essential to rest, avoid strenuous activity, avoid the use of tampons, sexual intercourse, and heavy lifting. Follow your doctor’s instructions about when you can resume normal activities. You will have a follow-up appointment with your doctor about two weeks after the surgery.

Hysterectomy Resources

Read more at:

– The American Congress of Obstetricians and Gynecologists Pamphlet on hysterectomy

– The National Women’s Health Information Center Frequently asked questions about hysterectomy


Endometrial ablation removes the lining of the uterus, also called the endometrium. NovaSure is the most common type of endometrial ablation.

Pros of Novasure Endometrial Ablation

– Less invasive than a hysterectomy

– It’s a 5-minute in-office and one-time procedure

– Menstrual periods lighten or stop within a few months

– Minimally invasive

People may have endometrial ablation to reduce heavy menstrual bleeding or if they do not want children. Some might elect for endometrial ablation if they have longer periods, experience bleeding between periods, or have low blood count because of heavy menstrual bleeding. A healthcare provider may also recommend an endometrial ablation for other reasons.

Menstrual cycles with heavy bleeding are one of the most commonly reported problems for people with the capacity for pregnancy, affecting more than 10 million Americans per year, according to the Centers for Disease Control and Prevention (CDC). Heavy bleeding is defined as needing to change your menstrual product after less than two hours or passing clots larger than the size of a quarter. Heavy menstrual bleeding can severely impact the quality of life. It can also cause anemia or lead to other health issues.

Endometrial ablation is a less invasive procedure than a hysterectomy. It avoids the hormonal changes that accompany total hysterectomies or the removal of the uterus, cervix, ovaries, and sometimes, the fallopian tubes. A menstrual cycle is the shedding of the endometrium. Because an endometrial ablation eradicates the temporary lining of the uterus that would be shed with a period, bleeding is lighter.

There are several forms of endometrial ablation: hydrothermal, electrical, balloon therapy, microwave, and cryoablation. NovaSure endometrial ablation is the most common form of endometrial ablation; 7 out of 10 endometrial ablation procedures are with NovaSure. Please see our blog post about Novasure endometrial ablation in Austin, Texas, to learn more about the procedure.

Cons of Novasure Endometrial Ablation

– Not for those who might want to become pregnant

– If pregnancy occurs, though rare, the risk of miscarriage increases

– Serious risks are rare but include infection, perforation, and thermal injury

According to the American College of Obstetricians and Gynecologists (ACOG), pregnancy after endometrial ablation is unlikely but can still occur. A pregnancy after receiving NovaSure increases the risk of complications such as miscarriage, as the uterine tissue cannot support fetal development. If someone wants to become pregnant, NovaSure is not recommended. For sexually active individuals after NovaSure, contraception is still recommended.

Call us today to discuss which option is right for you!