Techniques to reduce menstruation by endometrial ablation initially became possible with the advent of hysteroscopically guided ablations using laser and electrocautery by the late 90s. A variety of global second generation endometrial ablation devices began to be developed. These have simplified endometrial ablation, allow it to be undertaken in outpatient settings with reduced anaesthetic time.  They have improved the ease with which abnormal uterine bleeding can be performed with a high success rate and high patient satisfaction. These made them an excellent option for the conservative management of menstrual disorders. However, there are still potential issues in long term management that needs to be addressed.

We will review the various devices available and with a reference to their ease of use, cost and success rate.