Endometrial ablation is a common procedure performed to manage heavy or prolonged menstrual bleeding that has not responded to other treatments. The goal of the minimally invasive surgery is to destroy the endometrium, the tissue lining the inside of the uterus, to reduce menstrual flow. A frequent and expected part of the healing process is a watery vaginal discharge. Understanding the cause and normal progression of this fluid is helpful for recovery.
The Cause of Watery Discharge
The watery discharge is a direct and normal consequence of the procedure. Ablation techniques destroy the targeted endometrial tissue using heat, freezing, or radiofrequency energy. Once destroyed, the body recognizes this tissue as debris that must be expelled from the uterine cavity.
This expulsion process is known as sloughing, where the necrotic (dead) tissue separates from the uterine wall. The discharge becomes watery because the body uses natural tissue fluid, or serum, and other healing fluids to flush out the debris through the cervix and vagina. This expelled material is a mix of destroyed endometrial cells and the fluid used in the body’s natural cleansing response. The presence of this fluid indicates the uterus is actively clearing the remnants and beginning the process of forming scar tissue, which reduces bleeding.
Expected Duration and Changes
The watery discharge begins immediately following the procedure and can continue for a significant period during recovery. While some individuals notice it for only a few weeks, it is normal for the discharge to persist for four to six weeks. In some cases, a light discharge may continue intermittently for up to two months as deep healing completes.
The appearance of this fluid changes over the course of the healing period. Initially, the discharge is often mixed with blood, appearing pink or thin and bloody due to immediate post-operative bleeding. As the initial bleeding subsides, the discharge transitions to a clearer or more watery consistency. Later, as the remaining debris is cleared, the fluid may become yellowish or light brown before resolving completely. The volume may fluctuate, but the overall trend should be a gradual decrease over time.
When to Contact Your Doctor
While a watery or bloody discharge is a normal sign of healing, certain changes signal a potential complication requiring prompt medical attention. A discharge that develops a foul or strong odor is a primary warning sign, as this can indicate an infection within the uterus. Similarly, the appearance of a fever, defined as a temperature exceeding 100.4 degrees Fahrenheit (38 degrees Celsius), suggests an infection may be present.
Another serious sign is heavy bleeding, defined as soaking through one full-sized sanitary pad in an hour for two or more consecutive hours. This level of bleeding is outside the scope of normal post-ablation spotting and must be reported immediately to rule out a hemorrhage. Contact your healthcare provider if you experience intense pelvic pain or cramping not relieved by prescribed medication. If the discharge abruptly stops and is followed by severe, increasing pelvic pain, this could indicate a rare complication where fluid is trapped inside the uterus, requiring urgent evaluation.