Reducing Heavy Menstrual Flow
Many women suffer from heavy menstual periods. When these become a problem, women want options to help decrease or eliminate heavy menses from there lives. Hormone therapy, endometrial cryoablation, or a hysterectomy are some options that should be considered.
Not all women need ablations or even hysterectomies. Before the patient considers options to reduce the bleeding an evaluation should be performed. This begins with a simple a pelvic exam and a pap smear. Sometimes a course of birth control pills may be recommended in a young patient to see if these help decrease the bleeding.
However, as a woman gets older, other possible pathologic problems may occur. Therefore, further evaluation is indicated for these patients. These could include a vaginal sonogram to visualize the size of the uterus and the ovaries, and to possibly identify possible pathologic conditions present.
A special sonogram, called a hysterosonogram, with an endometrial biopsy may be recommended. This procedure is performed in the office with minimal discomfort. While performing a sonogram, fluid is injected inside the uterus to see if abnormal tumors or polyps are present within the uterus that may be causing the bleeding. An endometrial biopsy may also be performed at the same time. Here, a sample of the endometrial tissue is obtained to make sure that the heavy bleeding problem is not secondary to a precancerous endometrial condition.
Another procedure that may be necessary for further evaluation of the endometrium is a hysteroscopy. Here, a very small telescope is inserted into the uterus to visualize the inside lining of the uterus. In so doing we can see if there are problems inside this cavity that may be causing excessive menstrual bleeding. An endometrial biopsy may also be performed through this scope if necessary. The procedure is usually performed right in our office using just a local anesthetic on the cervix with minimal discomfort. You may resume normal activities immediately after the procedure is performed.
HOW THE CRYOABLATION PROCEDURE IS PERFORMED
After an adequate workup and no serious pathology have been found, you may be scheduled for the cryoablation procedure. The procedure is performed at our office while you are awake. Medications are given orally prior to the procedure to reduce any cramping you might experience, and you may request an oral tranquilizer for anxiety if you desire. A local anesthetic is then used to numb the cervix, similar to when the dentist uses a local anesthetic in your mouth to work on your teeth. Once the area is numb, the cervix is dilated and the procedure is performed without pain.
The procedure destroys the endometrial layer of cells by literally "freezing" them. Once the cells in this layer are destroyed, this endometrial lining of the uterus is essentially gone. Once destroyed, the lining does not respond to monthly hormonal stimulation. The result is that most women see minimal to no further enstrual bleeding again. At least eighty to ninety percent of women see a marked reduction in their menstrual flow to minimal levels and are satisfied with the results.
Thirty percent of women actually see no further bleeding. Most women find it hard to believe that treating their menstrual bleeding problems can be so easily performed. The cryoablation procedure makes this possible. After the procedure, usually women experience some cramping for that night, but this goes away rapidly and is treated with medications easily. Most women can go back to work or other normal activities the next day if they desire.
OTHER TREATMENT OPTIONS FOR HEAVY MENSTRUAL PERIODS iods
Medication "“ Hormonal therapy, such as birth control pills, may be prescribed for women who experience heavy menstrual bleeding due to a hormonal imbalance and who wish to preserve their fertility after treatment.
Dilation and Curettage (D & C) "“ This surgical procedure may provide a temporary solution to heavy menstrual bleeding and may be necessary for further evaluation of abnormal bleeding. The top layer of the lining of the uterus (the endometrium) is scraped away, usually under general anesthesia in an outpatient setting. It does not provide effective long term treatment for heavy menstrual bleeding.
Hysterectomy "“ The surgical removal of the uterus provides a final cure for excessive menstrual bleeding. Many women require this procedure because of complaints of pain in addition to heavy menstrual flow. Usually, Dr. True performs hysterectomies vaginally so no large incisions are needed. Further discussion on this and the different types of hysterectomies and procedure options can be discussed during your office visit.
WHAT TO EXPECT AFTER TREATMENT
After the endometrial ablation, most women experience some cramping that should go away by bedtime. The majority of women are able to return to normal activities the next day. You will probably have a pink or yellow watery discharge for several weeks after your treatment. If you experience two days of heavy bleeding, abdominal or pelvic pain, a fever, or pain that increases over time, you should call the office and come in to be evaluated.
ARE YOU A CANDIDATE
If you are tired of heavy menses, make an appointment today for an evaluation. Find out if you are a candidate for the quick in-office cryoablation procedure. We are here to help give you a better quality of life.