Can You Lose Weight After an Endometrial Ablation?

Dr. Christopher McGowan
November 14, 2023

Endometrial ablation is an outpatient surgical procedure that is seen as an alternative to a hysterectomy for some women who are afflicted with abnormally heavy periods. Apart from the risk of complications that come with virtually any kind of surgery, the procedure is relatively safe. Nevertheless, some women have reported fluctuations in their body weight in the weeks and months after the procedure. While there aren’t any direct reasons weight gain or weight loss should happen, there are some possible indirect reasons for such a change.

Overview of Heavy Menstrual Bleeding   

While the precise cause isn’t always clear, one of the most common reasons women go to see a gynecologist is heavy menstrual flow. As a part of the normal menstruation process, the lining of the uterus (technically referred to as the endometrium) is shed during each menstrual cycle if no fertilized egg is present. Tampons and pads are normally used to absorb the viscous menstrual fluid, but in some cases the bleeding is either too substantial or it lasts longer than the customary time.

Even besides the discomfort and other symptoms associated with this kind of abnormally heavy flow, it can also be physically and psychologically burdensome if left untreated. Heavy menstrual bleeding is typically defined as bleeding that lasts for 7 days or that requires the change of a pad or tampon every 1-2 hours. In order to determine the underlying cause, the doctor will perform a physical exam and/or a vaginal ultrasound. Below are some of the more common causes:

  • Hormonal imbalance: Fluctuations in hormonal levels, especially imbalances in estrogen and progesterone, can affect the regularity and flow of menstrual periods and interrupt ovulation.
  • Abnormal growths: Fibroids and polyps are two examples of abnormal growths that can occur in the lining of the uterus and cervix. While usually benign, the presence of these growths can disrupt the uterine lining and lead to heavy periods or even bleeding between periods.
  • Thyroid problems: Hypothyroidism and other problems with the thyroid gland can interfere with the activity of various hormones that govern the menstrual process. However, thyroid problems can also influence the production of proteins involved in blood clotting that results in excess bleeding.
  • IUDs: Intrauterine devices, especially those made of copper, can have a tendency to cause vascular changes and inflammatory responses that can promote heavy menstrual bleeding.
  • Endometriosis: Endometriosis is a condition in which tissue of the endometrium (the inner lining of the uterus) grows outside of the uterus. Unlike normal endometrial tissue that is shed during menstruation, the abnormal external endometrial tissue has no easy exit from the body. This can lead to inflammation, pain, and the formation of scar tissue, and it can also indirectly lead to heavier periods and bleeding.
  • Cancer: Though rare, endometrial cancer in the uterine lining can cause excess bleeding and sometimes vaginal discharge.

What Is Endometrial Ablation?

For most cases of excessive menstrual bleeding, over-the-counter drugs like ibuprofen can help reduce pain and discomfort. There are also various medications that can either promote blood clotting or regulate the hormones involved in menstruation. Also, some forms of birth control (like hormonal IUDs and traditional birth control pills) can help reduce menstrual blood flow. There are also some lifestyle changes, such as adopting a healthier diet or exercise plan, that are also known to improve symptoms.

In more severe cases, though, one of the main ways to bring relief is through a hysterectomy, a medical procedure that involves the total or partial removal of the uterus and cervix. However, because of how invasive the surgery is, it is typically chosen as a last resort. Endometrial ablation is an alternative procedure that is minimally invasive and effective about 85-90% of the time. Yet even though the uterus remains intact, having the procedure still does make pregnancy less likely in the future.

The basic goal of the ablation procedure is to eliminate the endometrial tissue that lines the uterine wall. By removing or destroying this tissue, the normal structure and function of the endometrium gets disrupted and is therefore less likely to respond to the hormonal signals that promote menstruation. There are a number of different techniques that can be used, and the decision of which one to use is typically based on the patient’s overall health and the size and shape of the uterus. Below are the most common types:

  • Electrosurgery: The best known version of this technique is called NovaSure, and it uses an electric current to gently remove or destroy the endometrial tissue. After a special electrode mesh is inserted into the uterus, electrical impulses vaporize and cauterize the endometrial lining.
  • Hydrothermal: Hydrothermal ablation involves filling the uterus with a special saline solution that is gradually heated; the heated fluid remains in the uterus until a sufficient layer of endometrium is burned away.
  • Balloon: Balloon ablation is similar to the hydrothermal approach, though instead of introducing a heated fluid to the uterus directly, it is added to a silicone balloon. The heated liquid then burns away tissue from inside the balloon.
  • Cryoablation: This technique uses cold instead of heat; after a special probe is inserted, extremely cold temperatures freeze and destroy the endometrial tissue.
  • Microwave: Through a probe, microwaves are emitted that achieve a similar kind of ablation.
  • Radiofrequency: Also known as rollerball ablation (because of the unique rollerball probe), this technique uses radio waves to ablate the endometrial tissue.

Endometrial Ablation and Weight Loss

Although endometrial ablation is minimally invasive, the procedure can have a number of side effects like bloating, cramps, or nausea. There is also a chance that excessive bleeding could lead to anemia. Some women have reported weight loss after the procedure, though nothing about the procedure is directly associated with weight loss. Below are some potential indirect effects that could potentially lead to a weight change:

  • Fatigue: Heavy menstrual bleeding prior to the procedure can lead to weakness and fatigue. This can indirectly promote less physical activity and a calorie surplus and eventual weight gain.
  • Fluid loss: Sometimes after a procedure like this the body loses a lot of fluids; even if only temporary, the loss of fluids could cause weight loss.
  • Appetite: Many patients experience anxiety and stress after a medical procedure, and this mental state can lead to a decrease in appetite.

Contact True You Weight Loss 

The bottom line: there isn’t much of a connection between endometrial ablation and weight loss. But weight loss remains a major goal for many Americans. At True You, we are passionate about providing a new path to long-term success that just isn’t possible with traditional methods like diet and exercise. To learn more about how True You can help you find the freedom you’ve been looking for, please contact us today to request a consultation.

Dr. Christopher McGowan
Dr. Christopher McGowan

Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.

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