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.
Read more on Sky News:
New workplace standards for menopause and menstruation support
Women more likely to suffer migraines during menstrual cycle
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
MPs to debate emergency law to keep British Steel open as prime minister warns national security ‘on the line’
MPs will today debate emergency laws to save British Steel after the prime minister warned the country’s “economic and national security is on the line”.
Sir Keir Starmer said the future of the company’s Scunthorpe plant – which employs about 3,500 people – “hangs in the balance” after its owner said the cost of running it was unsustainable.
The prime minister said legislation would be passed in one day to allow the government to “take control of the plant and preserve all viable options”.
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MPs and Lords are being summoned from their Easter recess to debate the move and will sit from 11am.
The last time parliament was recalled was on 18 August 2021 to debate the situation in Afghanistan.
The government has been considering nationalising British Steel after Jingye, the Chinese owner, cancelled future orders for iron ore, coal and other raw materials needed to keep the blast furnaces running.
The furnaces are the last in the UK capable of making virgin steel.
Jingye last month rejected a £500m state rescue package – raising fresh doubts about the Lincolnshire plant and fears it could close in the coming days.
The steel from the plant is used in the rail network and the construction and automotive industries. Without it, Britain would be reliant on imports at a time of trade wars and geopolitical instability.
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Inside the UK’s last blast furnaces
In a statement on Friday, Sir Keir said: “I will always act in the national interest to protect British jobs and British workers.
“This afternoon, the future of British Steel hangs in the balance. Jobs, investment, growth, our economic and national security are all on the line.”
The prime minister said steel was “part of our national story, part of the pride and heritage of this nation” and “essential for our future”.
He said the emergency law would give the business secretary powers to do “everything possible to stop the closure of these blast furnaces”.
This includes the power to direct the company’s board and workforce. It will also ensure it can order the raw materials to keep the furnaces running and ensure staff are paid.
The Scunthorpe plant is the last in the UK that can make virgin steel. Pic: Reuters
One of the two blast furnaces at Scunthorpe
Chancellor Rachel Reeves said the government was “taking action to save British steel production and protect British jobs”, while Business Secretary Jonathan Reynolds said the owner had left the government with “no choice”.
Mr Reynolds said Jingye had confirmed plans to close the Scunthorpe furnaces immediately despite months of talks and the offer of £500m of co-investment.
The company said it had invested £1.2bn since taking over in 2020, but that the plant is losing £700,000 a day.
Read more:
Govt intervention in British Steel ‘a remarkable step’ – analysis
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What will happen with British Steel?
Conservative leader Kemi Badenoch said the government had landed itself in a “steel crisis entirely of their own making”.
She said when she was business secretary, she had negotiated a plan with British Steel “to limit job losses and keep the plant running”.
Ms Badenoch said the government had “bungled the negotiations, insisting on a Scunthorpe-only deal that the company has deemed unviable”.
She added: “Keir Starmer should have seen this coming. But instead of addressing it earlier in the week when parliament was sitting, their incompetence has led to a last-minute recall of parliament.”
The Unite union said the prime minister’s recalling of parliament was “absolutely the right thing to do to begin the process of nationalisation”.
While the government hasn’t confirmed those plans, the chancellor also said earlier this week that “all options” are on the table.
Sky News understands accountancy firm EY is being lined up to play a role in a nationalisation process.
The government’s intervention over British Steel comes six months after the last blast furnace was closed at Port Talbot in Wales.
Plaid Cymru has questioned why the government didn’t take similar action there.
The party’s Westminster leader, Liz Saville Roberts, said: “Parliament is being recalled to debate the nationalisation of Scunthorpe steelworks.
“But when global market forces devastated Welsh livelihoods in Port Talbot, Labour dismissed Plaid Cymru’s calls for nationalisation as ‘pipe dreams’.”
Veteran cabinet minister Michael Gove has been awarded a peerage in Rishi Sunak’s resignation honours list.
Mr Gove – now editor of The Spectator magazine – was first elected to parliament in 2005 and immediately joined then-Conservative leader David Cameron’s shadow cabinet.
He was appointed education secretary when the party entered government in 2010 and held multiple cabinet posts until the 2024 general election, when he stood down from parliament.
Mr Sunak elevated seven allies to the House of Lords, including former cabinet ministers Mark Harper, Victoria Prentis, Alister Jack, and Simon Hart. Former chief executive of the Conservative Party, Stephen Massey, also becomes a peer, as well as Eleanor Shawcross, former head of the No10 policy unit. He also awarded a number of honours.
It is traditional for prime ministers to award peerages and other gongs upon their resignation from office – with key political allies, donors and staff often rewarded.
An outgoing prime minister can request that the reigning monarch grants peerages, knighthoods, damehoods or other awards in the British honours system to any number of people.
In the case of peerages, the House of Lords Appointments Commission vets the list, and for other honours, the Cabinet Office conducts checks.
Resignation honours are separate from dissolution honours, which are awarded by the incumbent prime minister and opposition leaders after the dissolution of parliament preceding a general election.
Here are the biggest names given honours by Mr Sunak:
Michael Gove – peerage
Former cabinet minister Michael Gove. Pic: PA
From when the Conservatives returned to government in 2010, Michael Gove spent almost the whole time in a ministerial role.
After reforming the education system, he went on to hold roles like chief whip, environment secretary, justice secretary and housing secretary.
He led the pro-Brexit side of the 2016 referendum alongside Boris Johnson, and famously sunk the latter’s leadership bid with his own.
However, both failed at that juncture, and Mr Gove’s reputation never recovered to allow him another go at the top job.
The debt was repaid when Mr Johnson fired Mr Gove as his administration collapsed in 2022.
Mr Gove returned to government under Rishi Sunak, and ultimately retired from the Commons at the 2024 election.
James Anderson – knighthood
Lancashire bowler James Anderson. Pic: PA
One of England’s most successful cricketers, Jimmy Anderson, has been awarded a knighthood in avid cricket fan Rishi Sunak’s resignation honours list.
He is regarded as one of the greatest bowlers in the history of the sport, and holds the record for the most wickets taken by a fast bowler in Test cricket.
Jeremy Hunt – knighthood
Jeremy Hunt.
Pic: Reuters
A former chancellor and serial runner-up in Tory leadership competitions, Jeremy Hunt was ever present in Conservative cabinets while the party was in government.
He was both foreign secretary and defence secretary before failing to take over the party after Theresa May stood aside.
Following a stint on the backbenches, Mr Hunt returned as chancellor under Liz Truss in a bid to stabilise markets – retaining this position under Rishi Sunak.
Despite persistent speculation he was set to be ditched in favour of Claire Coutinho, Mr Hunt kept his job until the 2024 general election – where he won his seat and now sits as a backbencher.
James Cleverly – knighthood
James Cleverly.
Pic: PA
A former leader of the Conservatives in the London Assembly, James Cleverly entered parliament at the 2015 general election as the MP for Braintree.
In 2018, he was appointed deputy chairman of the party, and in April 2019, was appointed a minister in the Brexit department.
Boris Johnson appointed him as party chairman after taking over the top job, and he took on a succession of junior ministerial posts before becoming education secretary following Mr Johnson’s resignation as prime minister.
Liz Truss appointed him as foreign secretary – a post he held until November 2023 when Rishi Sunak brought back David Cameron for the role, and he took over as home secretary – a post he held until the general election.
Mr Cleverly was one of the lucky cabinet ministers to survive the Labour landslide and retained his seat. But he was less successful in the Conservative Party leadership contest, losing out in the final round of MP voting.
Andrew Mitchell – knighthood
Andrew Mitchell.
Pic: PA
The former deputy foreign secretary has been a fixture in Westminster since 1987, when he was first elected as the MP for Gedling. He was appointed to the government in 1994, but lost his seat in the 1997 Tony Blair landslide.
He returned to parliament in 2001 as the MP for Sutton Coldfield, and took on a number of shadow cabinet and then cabinet roles, culminating in his appointment to the Foreign Office in 2022, before becoming deputy foreign secretary to David Cameron in 2024.
He rose to public prominence in September 2012 when he allegedly swore when a police officer told him to dismount his bicycle and leave Downing Street through the pedestrian gate rather than the main gate. The incident became known as “Plebgate”.
Mel Stride – knighthood
Shadow chancellor Mel Stride.
Pic: PA
One of Rishi Sunak’s closest aides, he chaired his campaign to be Tory leader against Liz Truss and was rewarded with the Work and Pensions brief when his man finally entered Number 10.
He was also a prominent figure in the downfall of Ms Truss as chair of the Treasury select committee – regularly requesting information from the Treasury and Bank of England that highlighted damaging information.
A capable media performer, he was ever present during the general election as he tried unsuccessfully to get Mr Sunak back into office.
Mr Stride kept his seat after the vote, and was rewarded by Kemi Badenoch with a role as shadow chancellor of the exchequer.
Stephen Massey – peerage
Stephen Massey
Described as a “sensible man” by former chancellor George Osborne, Stephen Massey was appointed chief executive of the Conservative Party in November 2022 after Rishi Sunak took over as leader in the coronation leadership contest following the collapse of the Truss government.
Having spent his career as a financial adviser, Mr Sunak probably thought he was a safe pair of hands in which to entrust the leadership of the party machinery as they built their war chest ahead of the general election to come.
The personal donations of £343,000 to the party and £25,000 to Mr Sunak’s leadership campaign also likely made him an attractive candidate for the job.
Has Rishi Sunak previously awarded honours?
Mr Sunak previously granted peerages to former prime minister Theresa May, Sir Graham Brady, the former chairman of the influential Conservative backbench 1922 committee, as well as his right-hand man Liam Booth-Smith on 4 July 2024 – the day of the general election.
He lost the election by a landslide to Sir Keir Starmer’s Labour Party, and resigned as prime minister that day. He remains in parliament as the MP for Richmond and Northallerton.
UK
This is a remarkable step by the government – and Donald Trump, China and Reform UK have all played their part
When the sun sets on Scunthorpe this Saturday, the town’s steelworks will likely have a new boss – Jonathan Reynolds.
The law that parliament will almost certainly approve this weekend hands the business secretary the powers to direct staff at British Steel, order raw materials and, crucially, keep the blast furnaces at the plant open.
This is not full nationalisation.
But it is an extraordinary step.
The Chinese firm Jingye will – on paper – remain the owner of British Steel.
But the UK state will insert itself into the corporate set-up to legally override the wishes of the multinational company.
A form of martial law invoked and applied to private enterprise.
That will come at a cost to the taxpayer.
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No number has been specified, but there are wages to pay and orders to make at a site estimated to already be losing £700,000 a day.
There is also clear frustration in government at how the Chinese owners have engaged in negotiations around modernising the Scunthorpe site.
“Jingye have not been forthright throughout this process”, said the business secretary in his department’s official announcement about the new laws.
Time is so tight because of the nature of the steel-making process.
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Inside the UK’s last blast furnaces
Once switched off, blast furnaces are very hard to turn back on.
If this had happened in Scunthorpe – as seemed likely in a matter of days – then it would have been game over.
This move keeps the show on the road and opens up more time for talks over the long-term future of the plant.
While the official line in Whitehall is that “all options are on the table”, nationalisation seems increasingly likely.
That would need more legislation, if it was done – as seems likely – without the approval of the current owner.
Finding an alternative commercial partner has not been ruled out, but one is not waiting in the wings either.
As for what that long-term future looks like, with just five years of life left in the Scunthorpe blast furnaces, modernisation is inevitable.
Port Talbot’s plant saw its blast furnaces closed last year amid a switch to the more environmentally friendly electric arc furnaces and a loss of thousands of jobs.
A general view shows British Steel’s Scunthorpe plant.
Pic Reuters
Political figures in Wales are now questioning why nationalisation wasn’t on the table for this site.
The response from government is that the deal was done by the previous Tory administration and the owners of the South Wales site agreed to the terms.
But there is also a sense that this decision over British Steel is being shaped by the domestic and international political context.
Labour came to power promising to revitalise left-behind communities and inject a sense of pride back into places still reeling from the loss of traditional industry.
With that in mind, it would be politically intolerable to see the UK’s last two blast furnaces closed and thousands of jobs lost in a relatively deprived part of the country.
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One of the two blast furnaces at British Steel’s Scunthorpe operation
Reform UK’s position of pushing for full and immediate nationalisation is also relevant, given the party is in electoral pursuit of Labour in many parts of the country where decline in manufacturing has been felt most acutely.
The geo-political situation is perhaps more pressing though.
Just look at the strength of the prime minister’s language in his Downing Street address – “our economic and national security are all on the line”.
The government’s reaction to the turmoil caused by President Donald Trump’s pronouncements on tariffs and security has been to emphasise the need to increase domestic resilience in both business and defence.
Becoming the only G7 nation unable to produce virgin steel at a time when globalisation appears to be in retreat hardly fits with that narrative.
It would also present serious practical questions about the ability of the UK to produce steel for defence and the broader switch to green energy production.
Then there is the intriguing subplot around US-China trade.
While this decision is separate from discussions with the White House on tariffs, one can imagine how a UK move to wrestle control of a site of national importance from its Chinese owner might go down with a US president currently engaged in a fierce trade war with Beijing.
This is a remarkable step from the government, but it is more a punctuation mark than a full answer.
The tension between manufacturing and decarbonisation remains, as do the challenges presented by a global economy appearing to fragment significantly.
But one thing is for sure.
As a political parable about changes to traditional industry and the challenges of globalisation, the saga of British Steel is hard to beat.
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