90-second treatment for heavy periods leaves some women in agony – and needing a hysterectomy
Thousands of women every year have an endometrial ablation on the NHS.
It’s a treatment for heavy periods – and for a lot of women, the 90-second procedure brings relief from the sapping cycle of heavy bleeding.
But the procedure to destroy the womb lining fails in up to a fifth of cases, often leaving women with no treatment options left but a hysterectomy.
People whose ablations have failed describe debilitating, long-lasting pain that fractures mental health, relationships and careers – and doctors who seem to have little idea what’s wrong with them.
Karen Ramage knew immediately after her endometrial ablation in 2021 that something wasn’t right.
The pain only got worse. The month prior, she had run 100 miles. By two weeks after the procedure, she couldn’t walk properly. She couldn’t drive, she couldn’t work, she could barely eat. And she couldn’t find a doctor who would agree the endometrial ablation might be to blame.
“My personal belief is that they just don’t expect anything to go wrong,” she told Sky News.
The discussion of risks beforehand was limited to being warned of adhesions between the womb and bladder or bowel, she says. She was told the worst outcome would be no improvement in her bleeding.
But constant pain set in down her right side, intensifying to “labour-like contraction pains” around the time of her period.
As months passed, she relied on daily doses of Tramadol. Talking to a counsellor, she tried to reckon with how she could live like this: “I felt that everything had been taken away from me.”
Karen Ramage had to pay for a hysterectomy privately after her ablation failed
It took going private for a doctor to tell her definitively her ablation had failed.
“I was probably more relieved that actually somebody would believe in me, because it was this whole thing that nobody would believe that this procedure had caused all of this.”
Facing up to a two-year wait on the NHS for a hysterectomy, she took out a loan to cover the £7,500 cost of having it privately. After months not working, it was a tough financial call – one that meant relying on food banks.
How ablations work – and fail
About one in four women suffer from heavy periods and more than 30,000 women in England had an endometrial ablation on the NHS between 2017 and 2022.
Most were radiofrequency ablations, where electromagnetic energy is used to burn away the lining of the womb.
The womb lining is what grows and sheds each month so the idea is that no lining means no – or lighter – periods.
But if not all the lining is destroyed, it still grows and sheds – but scar tissue can mean the blood gets trapped. It builds up in pockets behind the tissue, sometimes behind a scarred-shut cervix, causing intense pain until it disperses back into the body.
In women who have been sterilised the blood can back up into the fallopian tubes – this is known as PATSS (post-ablation tubal sterilisation syndrome).
In cases of late-onset failure, the lining regrows in the months and years after an ablation.
Some women experience pain cyclically each month, while for others post-ablation pain is constant or just during sex.
Women who spoke to Sky News describe agony worse than labour. One woman would put herself in the recovery position when the pain started because she knew she would blackout. Another came close to losing her job because she needed drugs so strong they made her a “zombie”.
‘Ablation ruined 10 years of my life’
Amanda Connor was told an ablation would “solve all my problems”, but three years later her womb had “completely grown back”. She decided to try the procedure a second time in 2010.
The pattern of monthly pain only intensified over time. It would start in her feet, a tingling fiery burn. By the time it reached her legs, she would be doubled over. Then it raged through her abdomen.
“I couldn’t stand up, I was on the floor writhing about and screaming for hours,” she told Sky News.
Her husband could only watch for so long before he would call an ambulance – just like he did the month prior, and the one before that.
At the hospital they would do the same checks for appendicitis, then pelvic inflammatory disease. But Amanda was sure they were looking for the wrong thing: “It’s not pelvic inflammatory disease, it’s happening every single month.”
Reports of not being believed or “gaslighting” were common among women who spoke to Sky News. One was told her pain must be a bladder infection. Two women were told it was IBS.
Nobody told Amanda it could be a failed ablation. She was the one who brought it up with her gynaecologist.
A scan revealed her womb was a “lump of scar tissue”. The only way to fix it was to remove her womb entirely.
She was shocked when her doctor told her: “Not only have I been totally misled about ablation and how amazing it is – I am now facing a major operation in order to fix it.
“If I could go back I would never have it done.
“Ablation ruined about 10 years of my life. The effect on my marriage, my work life and home life was huge.”
Taking legal action
Experiences like this are familiar to Dr Victoria Handley, a lawyer specialising in gynaecological medical negligence cases.
She estimates she’s handled about 1,000 cases relating to endometrial ablation since 2015. Every week she will hear from one or two women who have had complications from ablations.
They report adhesions of the uterus to the bladder or bowel, perforation of the uterus, infertility they weren’t warned about and ultimately needing further surgery.
Women are going to the doctor with heavy periods and ending up needing a hysterectomy, “the most radical thing you can have”, Dr Handley says. A hysterectomy carries risks including incontinence, sexual dysfunction, prolapse and early menopause.
“You’re swapping one problem for another without realising that the problem you’re swapping is actually worse than the problem you’ve got,” she told Sky News.
Dr Victoria Handley says she has handled about 1,000 cases
Exactly how many women suffer post-ablation complications is hard to pinpoint as research tends to only capture patients who have resorted to further surgery.
A study of more than 110,000 women in England who had an endometrial ablation between 2000 and 2011 found 16.7% had further surgery within five years. Other studies put the number at more than 20%.
Up to one in five ablation patients may have abnormal bleeding or period pain, or both, according to Professor Justin Clark, consultant gynaecologist and spokesperson for the Royal College of Obstetricians and Gynaecologists.
NICE guidelines set out treatment pathways for heavy bleeding. This includes taking a patient’s full history, investigating the cause of the bleeding and exploring conservative options like the coil and pill before an ablation.
A spokesperson for NHS England told Sky News staff should be following this guidance and “should make clear the benefits and potential risks of any recommended treatment so patients can make informed decisions”.
But Dr Handley says in her experience, “a lot of what’s in this guideline is ignored by the medical profession because they’ll go, ‘oh, I know what’s wrong with you’, and I’ll go straight to the surgery, and they don’t actually carry out the investigation and then send them down the correct route”.
Medical negligence cases need to establish a breach of duty; for endometrial ablation this is normally failure to warn of the risk of complications or failure to offer alternatives.
The claimant needs to prove they were injured, and the injury was caused by the breach. They also need to be able to show logically that had they been informed of the risks or alternatives, they would not have gone ahead with the ablation. If those four things don’t align, the case will fail, Dr Handley says.
The majority of cases are settled by NHS trusts out of court, she says, and women tend to receive upwards of £20,000, depending on the injury they have suffered.
Despite the number of cases she has dealt with, she says she has seen no attempt to solve the issue.
“The NHS response is woeful. There’s no joined up thinking at all. There’s no recognition that there’s an overarching problem, and there’s no desire to fix it.”
NHS England and NHS Scotland did not address questions from Sky News about how they are responding to this at an organisation-wide level.
‘It makes me sick to know my womb is burned’
Emma Burchell says she does not believe the risks were discussed in full when she had an ablation – which she calls “the worst decision I ever made”.
“You trust these doctors to do the right thing for you, and then you feel like they’ve not,” she says.
The months since the procedure in May 2022 have been “horrendous”. Constant sharp pain through her back, stomach and legs drove her to the doctor again and again, but she says she wasn’t given pain relief.
Instead she was offered antidepressants. She declined, worried she would be told the pain was “all in her head” if she accepted.
Now she’s considering a hysterectomy. “Do I need my womb?” she questions. “It makes me sick to know my womb is all burned, and it’s sat inside my stomach.”
But getting more surgery isn’t a quick fix. Gynaecological waiting lists in England have more than doubled since the start of the pandemic.
Emma has been put on injections to create a chemical menopause, a process which can help diagnose the cause of gynaecological symptoms, before doctors will consider a hysterectomy. In the meantime, each day is a “battle”.
Emma Burchell says getting an ablation was the ‘worst decision’ she’s ever made
Unsuitable candidates for ablation
A number of factors make an ablation more likely to fail: a younger age, fibroids, previous C-sections, polyps, a retroverted uterus (where the womb tips backwards) and adenomyosis (where the womb lining grows in the muscle of the womb).
According to Professor Clark, “endometrial ablation works best for women above 40 years old with relatively normal sized wombs without significant fibroids”.
Studies stress the importance of making sure women are good candidates for the procedure. A medical device alert from the UK’s Medicines and Healthcare products Regulatory Agency said the same.
Still, Sky News spoke to women who between them had all the contraindications above and had been given an ablation.
Karen Ramage found out after her ablation that she had a retroverted uterus – increasing the chance of ablation failure sixfold – as well as fibroids.
Ablations can be done where women have small fibroids, but she was told in her case it was like trying to “wallpaper over air bubbles and lumps, so it doesn’t cover the whole surface”.
When ablations work
Endometrial ablation support groups have sprung up on Facebook; the largest has more than 14,000 members, mostly in the US.
Women share stories of nerve damage, sepsis, infections, bloating, continued heavy bleeding. It’s nerve wracking reading for people considering the procedure – or who had it done before finding the group.
Samantha Williams hovers in the group, popping up in the comments to share her experience and reassure people. She had an ablation after 18 months of non-stop bleeding and it made a “massive difference” to her quality of life. It stopped the bleeding and hasn’t caused pain.
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If you think of treatments for heavy bleeding as the alphabet, she says, a hysterectomy is Z. With her NHS gynaecologist they worked through until they got to Y, an ablation.
The risks were explained, the patient information leaflet was detailed and she was confident it was right for her.
Still, her advice is the same as women who had bad experiences: “Do your homework. But also try everything else first. It shouldn’t ever be the first thing that you do. There’s lots of other options.”
What the NHS says
Sky News contacted NHS England and Scotland, as well as the NHS trusts that treated Karen, Amanda and Emma.
NHS England said endometrial ablation is “one of a number of treatments” for heavy bleeding that is given “when clinically appropriate”.
“While most women do not experience significant pain after this procedure, we strongly encourage any woman with concerns to speak to their clinician or GP,” it said.
A Scottish government spokesperson said “person-centred care” was a priority and involved working in partnership with patients to understand what they need, and how their desired outcomes can be achieved.
“An essential component of this approach involves providing tailored, understandable information so that people are fully informed and involved in decision-making about their care as much as they choose.”
A spokesperson for Bolton NHS Foundation Trust said: “We welcome the opportunity to speak with any patient directly if they had concerns about their care or treatment, so we can fully understand their experience and make improvements where possible.”
NHS Forth Valley again said it followed guidelines and best practice, adding that treatment options may be discussed at multidisciplinary team meetings to identify the most suitable options.
Follow up investigations would be carried out where there is ongoing pain or other symptoms, which could identify unrelated medical conditions as the source of pain, the spokesperson said.
UK
UK weather: Dozens of flood alerts in place across England and Wales amid warning of heavy rainfall
Dozens of flood alerts have been issued across England and Wales amid a warning of heavy rainfall.
The Environment Agency has 35 flood alerts in place for rivers in England, while Natural Resources Wales has another 10 in force as of midday on Saturday. Alerts mean flooding is possible.
It comes as the Met Office has a yellow weather warning in place for rain in the East Midlands, North East England and Yorkshire and Humber on Saturday.
Up to 30mm could fall “fairly widely”, the agency predicted, with as much as 60mm possible over higher ground. A yellow warning for ice is also in place for large parts of northern England overnight into Sunday.
Check the weather forecast where you are
There is also a yellow warning for rain on Monday covering North West England, Hampshire, South West England and Wales.
Up to 40mm is likely to fall quite widely for Derbyshire, North West England, and Yorkshire and Humber, and there could be as much as 120mm in a few places over the Cumbrian fells, the Met Office said.
In South West England, there could be up to 50mm “across the higher parts of Exmoor, Dorset, the Mendips and Cotswolds”.
Also for Monday, there is a more serious amber warning for rain in South Wales all day, with 120mm possible in a few places.
Rain warnings are in place for Saturday and Monday (below). Pic: Met Office
Homes and businesses could be flooded, the agency said, and there may be travel disruption and difficult driving conditions.
England and Wales normally averages just over 100mm of rainfall for the entire month of November.
Jason Kelly, chief meteorologist at the Met Office, said: “There is a clear signal for strong winds and periods of heavy rain, which could lead to surface water flooding and delays to road and rail travel.
“Rain will also push into North East England during Saturday, some of which could fall as snow over higher ground when the system meets colder air coming down from the north.
“Sunday will be drier and brighter, albeit colder, for many areas with blustery winds lingering near some North Sea coasts. Expect widespread frost overnight into Monday before the next weather system approaches.”
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Next week, the weather is expected to remain changeable, with occasional dry spells.
Homes across Scotland left without power
It comes after homes across Scotland were left without power following severe gales overnight.
The Met Office had issued a yellow weather warning for wind, covering Orkney, Shetland and western parts of the Highlands and Argyll and Bute, which expired at 11am on Friday.
Scottish and Southern Electricity Networks said gusts reached 83mph on the Western Isles and 75mph on the Isle of Mull.
A spokesperson said around 1,000 homes on the Isle of Mull were without power by mid-morning on Friday, but most have since been restored.
UK
Software issue impacts thousands of Airbus planes – as UK passengers warned of potential disruption
Airline passengers have been warned of potential travel disruption after Airbus identified a “significant number” A320 planes impacted by a software issue.
In a statement, the plane maker said: “Analysis of a recent event involving an A320 Family aircraft has revealed that intense solar radiation may corrupt data critical to the functioning of flight controls.
“Airbus has consequently identified a significant number of A320 Family aircraft currently in-service which may be impacted.”
File pic: iStock
It is understood the incident that triggered an unexpected repair involved a JetBlue flight from Cancun, Mexico, to Newark, New Jersey, on 30 October, which suffered a sharp loss of altitude which injured several passengers.
An Airbus spokesperson told Sky News the necessary software change would affect up to 6,000 planes.
They added that for most of the affected aircraft, the required software update would take 2-3 hours. However, some aircrafts would need new hardware to be able to adopt the required software and that those aircraft would be affected for longer.
Travel expert, Simon Calder, said the situation was “very concerning” but that he had full faith in the safety procedures of Airbus and airlines. He went on to say that “aviation remains extraordinarily safe.”
However, he warned that customers may not be entitled to cash compensation if affected by delays, as the issue would be considered out of the control of airlines.
EasyJet, British Airways, Aer Lingus, Lufthansa, American Airlines, Delta and Wizz Air are all affected by the issue.
Airbus told Sky News that it had proactively asked the European Union Aviation Safety Agency (EASA) to issue an air worthiness directive for the affected aircraft.
The issue is affecting A319, A320 and the A321 models. The company said the issue is only affecting A320s that are in service, not aircraft that are due to be delivered.
The UK Civil Aviation Authority said it is likely to mean some disruption and cancellation to flights.
Airbus requested that EASA issue an air worthiness directive. Pic: Reuters
Some airlines will be more affected than others, Colombian airline Avianca has announced that it will close ticket sales for 10 days due to the issue.
In a statement, easyJet said: “As we are expecting this to result in some disruption, we will inform customers directly about any changes to our flying programme tomorrow and will do all possible to minimise the impact.”
American Airlines said the Airbus software issue would impact 340 aircraft and it expects some operational delays due to a major software change requirement.
The airline added that it expects the vast majority of the updates to be completed by “today or tomorrow”, and that they are “intently focused” on limiting cancellations.
Wizz Air said some of its flights over the weekend may be affected, while Air India said the issue could lead to delays.
Indigo, an Indian airline which operates over 150 A320s, said it was proactively completing mandated updates on the affected aircraft.
British Airways told Sky News that only three of its aircraft where affected and that the required fixes will be carried out overnight and are not expected to disrupt its operations.
Aer Lingus is in a similar position, with a limited number of aircraft impacted. The Airline doesn’t expect there to be significant operational disruption, but is taking “immediate steps to complete the required software installations”.
In October, the Airbus A320 family broke a major milestone when it overtook Boeing’s 737 to become the most-delivered jetliner in history.
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Famous names affected by prostate cancer have spoken of their disappointment after mass screening for the illness was not recommended for use on the NHS.
The National Screening Committee (NSC), comprised of doctors and economists, told the government that screening is “likely to cause more harm than good”.
Its decision means the NHS is unlikely to offer mass screening for men over the age of 45.
Six-time Olympic gold-medallist Sir Chris Hoy, former Prime Minister David Cameron, Sir Stephen Fry, actor and author Tony Robinson and journalist Dermot Murnaghan, who have all been diagnosed with the disease, spoke out after today’s decision.
David Cameron, Dermot Murnaghan and Sir Chris Hoy were among those who spoke out. Pic: PA/Shutterstock/AP
In a draft recommendation, the committee said the reason it was “not recommending whole population screening using the prostate specific antigen (PSA) test was that it was likely to cause more harm than good”.
Instead, it proposes a targeted screening programme every two years for men with specific genetic mutations, known as BRCA-1 and BRCA-2, between the ages of 45 and 61.
But Sir Chris, who confirmed last year that his prostate cancer diagnosis was terminal, with doctors giving him two to four years to live, criticised the move.
The former Team GB cyclist, who confirmed in February 2024 that he was undergoing treatment, said: “I am extremely disappointed and saddened by the recommendation announced by the National Screening Committee today to rule against national screening for men at high risk of prostate cancer.
“More than 12,000 men are dying of prostate cancer every year; it is now the UK’s most common cancer in men, with black men at double the risk, along with men with a family history, like myself.
“While introducing regular checks for men carrying the BRCA genes is a very small step forward, it is not enough. I know, first hand, that by sharing my story following my own diagnosis two years ago, many, many lives have been saved.
“Early screening and diagnosis saves lives. I am determined to continue to use my platform to raise awareness, encourage open discussion, raise vital funds for further research and support, and to campaign for change.”
Sir Chris Hoy. Picture: PA
His views were echoed by Lord Cameron, who this month announced he was treated for prostate cancer last year.
Lord Cameron said in a post on X: “I am disappointed by today’s recommendation on prostate cancer screening from the National Committee.
“Targeted screening is a natural first step – but the recommendation today is far too targeted, not including black men or men with a family history, both high-risk groups.
“Prostate cancer is the most common cancer among British men. We are letting down too many men if we don’t push for a wider screening programme that includes all high-risk groups – and not just the men involved, but their families too, who risk losing a loved one unnecessarily. As I know all too well, prostate cancer can be symptomless early on.
“That’s why screening is so essential – catching the cancers early when they can be more effectively and successfully treated, like in my own case.”
Former British Prime Minister David Cameron said he was treated for prostate cancer last year. (AP Photo/Alex Brandon)
Sir Tony, journalist Mr Murnaghan and retired footballer Les Ferdinand also voiced their disappointment after the decision.
Sir Tony, 79, who starred as Baldrick in Blackadder, said: “I’m bitterly disappointed. Getting an early diagnosis for prostate cancer could save your life, but we still have no screening programme for it in the UK.
“I was lucky I found my cancer early, but nearly 10,000 men a year are diagnosed too late for a cure, and that’s just not right.”
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Why prostate cancer screening not being expanded
Broadcaster Mr Murnaghan, 67, added: “With prostate cancer cases higher than they’ve ever been, and the disease dominating the national conversation, I really thought we were heading to an exciting moment here.
“I’m so disappointed that the committee has decided not to recommend screening – it felt about time progress was made for men.”
He added in a statement shared with Sky News: “An acceptable halfway house, would perhaps be to extend screening to black men – and those with a known history of cancer in their family. But clearly a full nationwide screening programme would be best.”
Sir Stephen, who is a Prostate Cancer Research ambassador who revealed in 2018 he had undergone surgery after being diagnosed with the disease, said: “I’m deeply disappointed by today’s news. Men in the UK deserve so much better. Prostate cancer remains the second biggest cancer killer of men in this country, with more than 12,000 dying every year.
“The only way we will make a dent in that appalling statistic is by catching prostate cancer early, before symptoms appear – and the best way to do that is through a screening programme. I hope the country sees sense.”
Retired footballer Les Ferdinand also voiced his concerns over the decision. Pic: Reuters
Mr Ferdinand, whose grandfather died from prostate cancer, added: “I’ve seen members of my family survive prostate cancer, because their cancer was found in time.
“Without a national screening programme, the responsibility to find prostate cancer early and in time for a cure rests entirely on men’s shoulders, and it shouldn’t be this way.
“Black men are at double the risk of prostate cancer and twice as likely to die, and something has to be done.”
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Prostate cancer decision ‘a massive mistake’
Colin McFarlane, an actor who was diagnosed with prostate cancer in 2023, told Sky News presenter Jonathan Samuels the decision was a “massive mistake”.
“I’ve been diagnosed with prostate cancer, but I’m not having any treatment. I have something called active surveillance, so every three months I have a PSA blood test, and then once a year I have an MRI,” he said.
McFarlane said black men over the age of 45 are at high risk, and “should be invited for screening”. He added: “I personally think men over 50 should be invited for screening, because they’re also at risk. I’m concerned now for all the black men out there who are high risk.”
NSC added it did not recommend extensive screening for black men due to a current lack of evidence and data.
The committee also does not recommend targeted screening for men with a family history of the disease, who are also at a higher risk of prostate cancer.
The National Screening Committee is comprised of doctors and economists. File pic: iStock
Health Secretary Wes Streeting said he would consider the findings ahead of March’s final decision, adding that he wanted to see earlier diagnosis and quicker treatment, but that needed to be balanced against “the harms that wider screening could cause to men”.
Professor Sir Mike Richards, a former national cancer director and chairman of the NSC, told a briefing that modelling on PSA shows “whole population screening may lead to a small reduction in prostate cancer deaths, but the very high levels of overdiagnoses” means the harms outweigh the benefits.
Experts are also waiting to see data from a large trial launched by Prostate Cancer UK last week into whether combining PSA with other tests, such as rapid MRI scans, may lead to recommending population-wide screening.
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Why prostate cancer is expected to be left without national screening
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The trial is looking at the most promising screening techniques available, including PSA blood tests, genetic tests and 10-minute MRI scans, and whether they can be combined for a national screening programme.
The results will be ready within two years, it is hoped.
Mr Streeting added: “In the meantime, we will keep making progress on cutting cancer waiting times and investing in research into prostate cancer detection – in the last 12 months, 193,000 more patients received a diagnosis for suspected cancer on time.
“We are also providing funding to the £42m TRANSFORM trial, which has the potential to revolutionise prostate cancer screening, cutting out harmful side effects and making screening far more accurate.”
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