Excessive menstrual bleeding affects millions of women every year. Women who are affected suffer decreased quality of life, reduced productivity in the workplace and the constant threat of inconvenience or embarrassment. Chronic health conditions such as fatigue and anemia can result from heavy bleeding. Until recently, women were expected to suffer with the bleeding, take hormonal medications or have a traditional hysterectomy with a large abdominal incision. Today’s women are offered many newer options. Women suffering from heavy menstrual flow should talk with their healthcare provider about the options that may be appropriate for them. These generally include:
NSAID therapy. Medications such as Motrin®, Advil® or Aleve®, taken three to five days prior to menstruation, may reduce bleeding up to 30%. This treatment requires very regular cycles in order to work well.
Hormonal therapy. Hormones either in the form of oral contraceptive pills or cyclic progesterone can induce a regular and lighter flow. This treatment is very effective to induce regular menstrual cycles and may have the added benefit of improving acne and PMS.
Hormonal intrauterine system. Mirena® is a device that slowly releases progesterone in the uterine cavity. This dramatically reduces or even eliminates bleeding by keeping the lining very thin and healthy. It is an excellent alternative for people who want to avoid oral hormonal therapy. This requires only a simple office procedure, minimal discomfort and no down time.
Global endometrial ablation. Done in the office or operating room, this technique uses thermal energy to destroy the lining of the uterus, resulting in significantly decreased uterine bleeding. 85% of people will see reduced or even absent menstrual flow following ablation.
- This surgery is now often done on an outpatient basis with tiny incisions using traditional laparoscopic techniques or with the newer da Vinci robotic surgical system. These minimally invasive surgical procedures offer definitive treatment, and patients are able to get back to their lives quicker than ever before and with less pain. No longer are large abdominal incisions,extended hospital stays and long recoveries usually necessary.
Women experiencing excessive menstrual bleeding that affects their ability to enjoy a happy and productive life should speak with their provider about the treatment options that might be right for them. It is no longer necessary to plan family, recreational and work activities around episodes of heavy menstrual bleeding. Newer options available today make it easier than ever to be free from the uncertainty of heavy or irregular menstrual flow. Despite the newer nonsurgical options, hysterectomy is sometimes necessary. When performed in a minimally invasive way, women can get back to doing the things they enjoy faster than ever before.
Jennifer Fuson, MD Lexington Women’s Health