What to Do About Heavy Bleeding???

Do you miss work or limit your activities because of your periods?
Do you ever soak through your clothes? (see entry #2- I know I have and even had my male partners tell me I have blood on my clothes. UGH! )
Do you stay close to a bathroom during your periods? (well, I stay close to the bathroom all the time :)
Does bleeding limit your intimate time with your partner? (I wish that was my only excuse)
Do you need to take iron to keep from becoming anemic?


It is not normal to have your menstrual periods control your life!! There's too many contenders for that positon- kids, husband, job- you get my drift. Heavy menstrual bleeding (menorrhagia) is a common problem for women. The worst cases of excessive menstrual bleeding can cause severe anemia and even require blood transfusions.

When you know all your options up front you can make a more informed decision about which is right for you. Here's just a general overview of what I can do to treat your heavy bleeding but we'll have to talk about the specifics for your medical history, age and future plans for childbirth. And certainly, we may need to do some tests first (like an ultrasound) to see which option is best for YOU. Several factors will be important to your decision, including whether or not you plan to have children in the future and whether you want ongoing therapy or a one time treatment.

So here's a list of some options to fix this common problem:


1. Medicines: The simplest treatment is the use of hormones such as birth control pills or progesterone pills. Most bleeding caused by hormone imbalance can be treated with medications. However, many women are unable to use this option due to side effects or other medical problems. Also, some women simply just don't want to take a birth control pills.
Some prescription "cousins" of ibuprofen may decrease heavy flow, but may lengthen the time of bleeding.

2 Progesterone IUD: The Mirena® progesterone IUD (www.mirena-us.com)
may decrease bleeding. This IUD was recently FDA approved for the treatment of heavy bleeding. Prior to this FDA approval, physicians were just using it "off-label" for menorrhagia. It can, however, cause irregular bleeding and occasionally have some other side effects of moodiness, acne, and pain .It is a good option for women that want to conceive in the future as you can become pregnant within 1 month of its removal.

3. Endometrial ablation: Endometrial ablation is a quick (about 2 minutes) office procedure, that will usually eliminate or greatly decrease bleeding. After the procedure, over 95% of women will be satisfied with the results. Approximately 60-70% will no longer have any more periods. Another 20-30% will have very light periods only using a pantiliner throughout the period. Approximately 10% will fail the procedure and choose to manage bleeding as they have been doing, use hormones to control bleeding or opt for other surgical treatments.
It is also very important to understand that you should not become pregnant after an ablation.

4.Hysterectomy: This is the only procedure that guarantees permanent elimination of any bleeding. In my opinion, itt usually makes sense to consider less invasive alternatives before having major surgery. A hysterectomy is the removal of the uterus and cervix but not necessarily the removal of the ovaries. When a hysterectomy is the best option for you, I want you to have the LEAST invasive- which means FASTEST recovery- option. So then you can get back what's more important- family, friends and job. Who has 6 weeks to recover from a sugery these days? Laparoscopic hysterectomy (www.gynecare.com) is the most common way that I choose to remove a patient's uterus and cervix. This surgery usually takes 45-60 minutes to perform and you would stay in the hospital for 10-23 hours.Most patients are back to work in 2 weeks sometimes even sooner.

Hope this overview helps, but come talk to me about your specific situation and we'll talk about what's the best for YOU!

For more reading, here's a reputable website http://www.uptodate.com/online/content/topic.do?topicKey=gen_gyne/4741&selectedTitle=1%7E147&source=search_result#PATIENT_INFORMATION