Endometrial ablation is a procedure performed to address heavy or prolonged menstrual bleeding (menorrhagia). This treatment involves intentionally destroying the endometrium, the tissue lining the uterus. By removing this tissue layer, the procedure aims to significantly reduce the amount of blood lost during menstruation, often stopping periods entirely. Following ablation, patients commonly experience a thin, watery vaginal discharge. This post-operative discharge is a normal and expected part of the body’s healing process.
Why the Watery Discharge Occurs
The watery fluid occurs as a direct result of the body’s natural response to the treated uterine lining. Endometrial ablation uses methods like heat, freezing, or radiofrequency energy to destroy the tissue responsible for menstrual bleeding, causing the cells to die (become necrotic).
The body must flush out these dead endometrial cells and tissue fragments as part of the healing process. The discharge is primarily composed of serous fluid, a clear, thin, yellowish fluid secreted by tissues in response to injury. This fluid mixes with the sloughing tissue, creating the characteristic watery appearance.
This mechanism is similar to how a wound secretes fluid as it heals, as the uterus is healing an internal wound where the lining was removed. The discharge acts as a cleansing agent, carrying away the debris from the destroyed endometrium.
The discharge is evidence of the intended tissue destruction and subsequent healing, not a sign of the procedure failing.
The Expected Timeline and Appearance
The watery discharge typically begins immediately after the procedure and is heaviest during the first few days post-operation. During this initial phase, the fluid is often very thin, sometimes appearing pinkish-tinged due to a small amount of residual blood.
As healing progresses, the appearance changes gradually. It can transition from pink or clear to a brownish or yellowish color, resembling old blood or a light stain. This color change indicates the body is eliminating debris and the discharge is resolving.
The consistency should remain thin and watery, not thick or mucous-like, throughout the recovery period. While the volume lessens after the first week, it is normal for the discharge to persist for two to four weeks. A very light, intermittent watery discharge may continue for up to a couple of months as the uterus completes its internal healing.
Signs Requiring Immediate Medical Attention
While mild cramping and discharge are expected, certain symptoms indicate a complication, such as infection or hemorrhage, requiring immediate medical evaluation. Patients must watch for a significant increase in vaginal bleeding. Soaking through more than one standard sanitary pad per hour for two or more consecutive hours requires prompt medical attention.
A fever over 100.4°F suggests a possible uterine infection. A change in the discharge, such as developing a foul or unpleasant odor, often signals a bacterial infection. This may be accompanied by unrelenting abdominal pain not relieved by over-the-counter medication.
Other concerning symptoms include severe nausea or vomiting, difficulty passing urine or stool, and signs of a deep vein thrombosis (DVT). DVT symptoms include new pain, swelling, or warmth in one leg. Any severe or worsening symptoms warrant an immediate call to a healthcare provider.