A probe having a high intensity focused ultrasound (HIFU) transducer is positioned in a female patient. The HIFU transducer is deployed within the vagina of the patient outside of the cervix and uterine cavity and is configured to direct HIFU energy to a treatment site within the uterus of the patient. An imaging component positioned relative to the patient images a portion of the patient's uterus that includes the treatment site to help guide the delivery of the HIFU energy to the treatment site. A liquid medium may be infused into the uterine cavity of the patient where it is maintained during imaging and delivery of the HIFU therapy. The HIFU transducer produces a thermal heating of tissue at a focus within the treatment site to initiate necrosis of the tissue. The location of the focus is controlled in accordance with an image obtained by the imaging component.