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Thermal ablation is an alternative to surgical hysterectomy for the removal of the uterus, usually to treat fibroids and/or heavy menstrual bleeding. The procedure causes layers of the endometrium to collapse on each other and form a scar, so that there is no further bleeding. There are two main methods of thermal ablation, bipolar radiofrequency (RF) endometrial ablation and hydrothermablation, radiofrequency ablation being preferred by most doctors because it tends to have fewer complications.

It's not unusual women who have any kind of endometrial procedure to gain weight. At least 36 percent of women who have these procedures gain 10 pounds (about 5 kilos) or more.

It's usually a downward cycle something like this:

  • Changes in hormone levels results in joint pain.
  • Joint pain results in lessened activity.
  • Lessened activity results in weight gain.
  • Weight gain is depressing, and women self-medicate with food, especially sugar, resulting in more weight gain, more joint pain, even less activity, and even more depression.
Even worse, the weight gain is usually rapid, which makes it even harder to reverse. 

All of these effects are worse with hysterectomy. The surgical procedure cuts through ligaments that hold the pelvic bones in place. The pelvis bones separate and the hips grow wider. The spine compresses, and the rib cage is pulled closer to the hip bones. The waistline is replaced by a bulging belly, even without weight gain. The shift in the body's center of gravity causes chronic back pain. There is also a shift in body fat, which tends to accumulate over the abdomen. This presses on internal organs so that there are more digestive upsets, and more problems with enzyme and hormone secretion. The gut can't as easily communicate with the brain to tell it the stomach is full, and aches and pains multiply as weight gain continues.

The effects of thermal ablation aren't quite as bad at first, although they can snowball so a woman feels bloated and tired and achy all the time.  What can women do to prevent this?

  • Know that you will need to fight weight gain after your thermal ablation procedure. Plan to make changes in your diet and exercise routines as soon as you are able to get up and around again. This is usually just a few days.
  • Drink more water. The extra water helps prevent constipation, which helps prevent bloating, which reduces strain on your back, which makes it easier to move and exercise.
  • Make sure you get soluble fiber from fruit and vegetables each and every day. This also reduces constipation and reduces the impact of all the other changes to your torso caused by the procedure.
  • Rest! It's hard to find time to do all the things you have to do, but if you can get eight hours sleep every night, your body has time to regulate appetite, fat storage, and muscle preservation much more successfully than if you get six hours of sleep every night or even less. It's not necessary for most women to get more than nine hours of sleep, however.
  • Especially if you have not have an oophorectomy (removal of the ovaries), be careful to limit sugar consumption. If you just have to have your sweets, have a small piece now and leave something for tomorrow. The combination of sugar consumption and the other changes in your body that go along with thermal ablation can cause a condition that is "not quite polycystic ovarian syndrome." Hormone disturbances are made worse by insulin resistance, which you can avoid by doing the impossible: Weight loss by cutting back on calories, especially sugars and simple carbohydrates.

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