Menorrhagia affects at least 1 in 5 women and is defined as heavy or prolonged menstrual bleeding or bleeding that disrupts a woman’s routine activities. Menstrual bleeding is considered to be heavy if it exceeds 80 ml per day which is equivalent to about 8 soaked pads daily or if it lasts for more than 7 days.
There are multiple causes of menorrhagia. These causes include hormonal problems, blood clotting disorders, and ovarian dysfunction. Additional causes include medications such as blood thinners, anti-inflammatory agents, hormonal medications such as estrogens and progesterones and uterine abnormalities including fibroids, adenomyosis, polyps and pre-cancerous and cancerous changes of the uterus.
In order to diagnose the cause of menorrhagia, we will need to perform an evaluation that involves several different tests. The first step in this process after discussing your problem with you is a pelvic exam. Thereafter, we may perform blood tests to check certain hormone levels or blood clotting factors. We may also perform and ultrasound, an endometrial biopsy, a D&C or hysteroscopy.
Once the underlying cause of your bleeding has been determined, there are multiple treatment options that can be employed. These options include medications such as birth control pills, progesterones, anti-inflammatory agents like ibuprofen and the progesterone-containing IUD called Mirena.
In certain situations, surgery is appropriate to treat the menorrhagia. Surgical procedures include dilation and curettage of the endometrium, endometrial ablation, and hysterectomy.
Endometrial Ablation for Treating Menorrhagia
As you can see there are a lot of treatment choices for menorrhagia and making the right choice can often be confusing. A very successful treatment method and the method that we are most frequently asked about is the endometrial ablation. When women have completed their families and have no desire for future pregnancies, this has become a very popular choice to treat what patients perceive to be heavy bleeding due to the fact that it provides outstanding results, patients typically recover from it very quickly and it can be performed in the comfort of your doctor’s office.
The goal of this procedure is to eliminate the menstrual lining of the uterus, known as the endometrium, so that the menstrual cycles are eliminated or markedly reduced. There are several methods of accomplishing this, but independent studies indicate that the Novasure endometrial ablation creates the most reliable and successful outcomes of the different methods with the fewest side effects. This procedure takes 1-2 minutes and 95% of women who have undergone the procedure are satisfied with their results and would recommend it to their friends. It is usually performed with sedation and local anesthesia. This procedure has truly revolutionized our practices by eliminating 80 – 90% of the hysterectomies that we used to perform for abnormal bleeding and has improved hundreds of our patients’ lives without exposing them to the risks of hysterectomy and hospitalization. It has also freed them from the restrictions that their heavy bleeding had placed upon them.
If you suffer from heavy menstrual bleeding, or if you are interested in learning more about the endometrial ablation, please discuss this with Dr. McDyer or Dr. Suhrer so that he can answer your questions and assemble a proper diagnostic and treatment plan for you.