MyoSure and endometrial ablation are not the same procedure. They target different structures inside the uterus, work through completely different mechanisms, and serve different clinical purposes. MyoSure is a tissue removal system designed to cut out specific growths like polyps and fibroids. Endometrial ablation destroys the uterine lining itself to reduce or stop heavy periods. The two are sometimes performed together in the same session, which is likely why they get confused.
What MyoSure Actually Does
MyoSure is a brand-name hysteroscopic morcellation device. It uses a tiny rotating blade (just 2 millimeters wide) housed inside a slim outer tube that’s inserted through the cervix and into the uterus. The blade spins and reciprocates behind a small side-facing window in the tube. Targeted tissue gets pulled into that window, cut away, and suctioned out through the device into a collection canister. Think of it like a miniature, precision vacuum that shaves off unwanted growths piece by piece.
The FDA cleared MyoSure specifically for removing submucous fibroids (the kind that bulge into the uterine cavity) and endometrial polyps. Its design is meant to be selective: it removes the growth while leaving the surrounding healthy lining largely intact. This is a key distinction, because preserving the endometrium matters if you want to keep your fertility options open.
What Endometrial Ablation Does
Ablation takes the opposite approach. Instead of targeting a specific growth, it deliberately destroys the entire endometrial lining so it can no longer build up and shed each month. Several energy sources can accomplish this: radiofrequency (a mesh device that heats the lining), freezing, heated fluid, or microwave energy. The goal in every case is the same: permanently reduce or eliminate menstrual bleeding.
Ablation is recommended when heavy periods are the primary problem, typically defined as soaking through a pad or tampon every two hours or less, bleeding that lasts longer than eight days, or anemia caused by excessive blood loss. It’s not appropriate if you have uterine cancer or an increased risk of it, an active pelvic infection, or certain structural abnormalities of the uterus.
Results vary, but roughly 30 to 40% of women report their periods stop entirely within the first year. By two to five years after ablation, about half achieve complete cessation of periods. Most others see a significant reduction in flow, though a small percentage don’t get enough relief and eventually pursue a hysterectomy.
The Biggest Difference: Fertility
This is where the distinction between MyoSure and ablation matters most. Because MyoSure removes specific growths while preserving the uterine lining, it’s commonly offered to women who still want to become pregnant. Removing a polyp or fibroid that’s distorting the uterine cavity can actually improve your chances of conception.
Ablation, on the other hand, is only for women who are done having children. Destroying the endometrial lining makes it extremely difficult for a fertilized egg to implant and grow normally. The estimated pregnancy rate after ablation ranges from 0.24% to 5.2%, and those pregnancies carry serious risks: a 20-fold increase in dangerously adherent placenta, higher rates of miscarriage, ectopic pregnancy, uterine rupture, and emergency cesarean delivery. Reliable contraception after ablation is essential.
Why They’re Sometimes Done Together
If you have both a structural problem (like a polyp or small fibroid) and heavy bleeding caused by the lining itself, your doctor may recommend both procedures in a single visit. A clinical protocol published in the Journal of Minimally Invasive Gynecology studied exactly this combination: MyoSure first to remove the growths, followed immediately by NovaSure (a common radiofrequency ablation device) to treat the lining. In that study, total procedure time for both steps was about 18 minutes, and 100% of the targeted tissue was removed with no serious complications.
The logic is straightforward. Ablation works best on a smooth, empty uterine cavity. If polyps or fibroids are present, they can interfere with the ablation device’s ability to make full contact with the lining. Clearing them out first with MyoSure gives the ablation the best chance of working. This combined approach is positioned as an alternative to hysterectomy for women with abnormal uterine bleeding who no longer want to become pregnant.
Procedure Experience and Recovery
Both procedures are minimally invasive and performed through the cervix with no external incisions. They can often be done in an office or outpatient setting rather than a hospital operating room.
Recovery from ablation is quick. Most people return to normal activities within 48 hours. Common side effects include mild nausea, cramping for one to three days, increased urination on the first day, and light bleeding or watery discharge that can last a few weeks (heaviest around 48 to 72 hours after). You’ll typically be asked to avoid sex and tampons for a few days.
MyoSure recovery follows a similar timeline, though the specifics depend on how much tissue was removed. Removing a small polyp is a lighter procedure than morcellating a larger fibroid, so recovery can range from essentially immediate to a few days of mild cramping and spotting.
How to Think About Which One You Need
The simplest way to understand the difference: MyoSure treats what’s growing inside the uterus, while ablation treats the uterine lining itself. Your diagnosis determines which procedure fits.
- Polyps or fibroids causing symptoms: MyoSure (or a similar tissue removal device) targets and removes the growth.
- Heavy periods without a structural cause: Ablation destroys the lining to reduce bleeding long-term.
- Both problems at once: The two procedures can be combined in a single session.
- Future pregnancy desired: MyoSure preserves fertility. Ablation does not.
If your doctor has recommended one or both, the key question to clarify is what’s actually causing your bleeding. An ultrasound or hysteroscopy (a camera inserted into the uterus) will show whether polyps, fibroids, or the lining itself is the source of the problem, and that imaging guides which procedure makes sense for you.