Objective To describe the introduction of microwave endometrial ablation to clinical practice, and to report the outcomes three years after endometrial ablation.Design A clinical trial using prototype microwave endometrial ablation equipment.Setting District general hospital.Population Forty‐three women with completed families and with failed medical management for men‐orrhagia were treated with microwave endometrial ablation between October 1994 and April 1995.Main outcome measures A statement of perceived menstrual loss and satisfaction supported by a menstrual symptom questionnaire score. Dysmenorrhoea was graded as a measure of described severity. Treatment time.Results Forty‐three women had a total of 46 treatments. Mean treatment time: n= 43, was 141 seconds (50–310). Amenorrhoea: n= 16; 37.2%. Very light periods/discharge: n= 11; 25.6%. Improved periods and woman satisfied: n= 9; 20.9%. Improved periods and woman not satisfied: n= 1; 2.3%. Overall satisfaction at three years is 83.7%. Moderate (55.8%) or severe (27.9%) dysmenorrhoea pre‐operatively had improved to 11.6% and 6.8% respectively at three years. Three re‐treatments and four hysterectomies will be discussed.Conclusions Microwave endometrial ablation is a new treatment for dysfunctional uterine bleeding using the application of microwave energy to the endometrium. This results in a rapid but restricted depth of intrauterine heating avoiding hysteroscopic fluid, operative haemorrhage and earthing risks. The technique is simple to learn and perform. Women report a high level of satisfaction three years after microwave endometrial ablation.

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