Solution for Heavy Periods

GLOBAL

GYNECOLOGY INSTITUTE

The 10-Minute Solution for Heavy Periods

More than 1 in 5 women in their 30s and 40s suffer from heavy periods. Heavy periods can be very frustrating for all women, those staying at home or working. The challenges are many – the clothes to wear in case staining occurs, pain and cramping in the lower abdomen, and an extended menstrual cycle. In addition, it affects the quality of your personal, family and work life and you are often at a dilemma as to how it can be dealt with.

There are various causes for heavy bleeding. In about 20% patients with heavy bleeding, the uterus is of normal size, yet bleeding is very heavy and often unmanageable.

Frequently Asked Questions When is bleeding considered heavy?

Bleeding is considered heavy when it is abnormally long, is unmanageable, when there is passage of large clots, and when there is a constant need to change pads or tampons. However, you are the best judge as it is mainly your perception about the deviation from the normal.

What is Dysfunctional uterine bleeding (DUB)?

DUB is excessive bleeding from the vagina, which is not associated with any tumor or cyst in uterus, ovaries and fallopian tubes.

How is DUB diagnosed?

A diagnosis is made after careful evaluation only. Thus, your doctor will take a thorough history, do a complete examination including pelvic ultrasound, (and perhaps as hysteroscopy and endometrial biopsy), and also conduct relevant lab investigations before making the diagnosis of DUB or organic cause of heavy bleeding.

Is it dangerous for my health?

Any disorder, however small has the potential of escalating into a grave one if left untreated. DUB leads to growing fatigue and tiredness due to anemia and breathlessness in day-to-day activities. It also impacts sexual life. In addition, during the periods of heavy bleeding, you may have to take frequent leave from work.

What are the treatment options? Do I need to get my uterus removed?

Not at all, in fact uterus removal or hysterectomy is the absolute last option, irrespective of either it is of normal size or bulky. The choice of treatment depends her age, severity of bleeding and need to retain fertility.

What are the various treatment modalities available?

Your doctor can either recommend medical treatment in the form of drugs which are effective in one-third of the time. However, the latest treatment is the Global endometrial abortion procedure, which involves the destruction of the lining of the uterus; and insertion of MIRENA, an intrauterine device containing levonorgestrel.

What is Global endometrial ablation?

Global endometrial ablation is a process in which the endometrium (innermost lining of uterus) is destroyed by various methods. The common process used in Thermal Balloon Ablation (or Uterine balloon therapy) and Transcervical resection of the endometrium (TCRE), which is a less drastic alternative.

What is Uterine balloon therapy?

Uterine balloon therapy is a new outpatient procedure to reduce excessive menstrual bleeding. Unlike hysterectomy, which takes out the entire uterus, the procedure just destroys the lining of the uterus by the use of heat. Suffice to say that it is a 10-minute solution for heavy periods. It is simple and safe; and is a successful procedure in which a disposable balloon is passed into the uterus and the endometrium (lining of the uterus) is destroyed by raised fluid temperature in the balloon. The process is fully computerized. The process requires no cuts or stitches. The procedure can be done under light anesthesia, and is safe even for patients who have medical problems such as uncontrolled diabetes,

high blood pressure, blood cancer, heart or kidney disease like kidney failure, where major operations are risky to perform. It results either in permanent stoppage or marked reduction in menstrual bleeding, and is therefore this procedure is appropriate for women who have completed their family. The patient needs to be in the hospitals for only few hours and does not need to rest at home after the procedure. She is fit to resume work the next day.

How successful is it?

Clinical studies over 10 years have shown Uterine balloon therapy to be a reliable and very effective treatment in about 95% women. In fact, gynecologists all over the world use various endometrial ablation techniques with almost similar results. With proper selection of cases, (ie, excluding cases of fibroid uterus, uterine cancer, and ovarian cysts) the results show 97-98% success, when the woman enrolled are carefully selected.

What about fertility and contraception?

The treatment is not recommended for women who would like to be pregnant in the future.

What if drug therapy has failed and I do not want to undergo any surgical intervention?

In such an instance, the coice of treatment would be Mirena速. Mirena速is an intrauterine device which is effective for 5 years with the added advantage of contraception. Fertility remains intact after removal.

However, the effect is not immediate and the full benefit of Mirena速 is seen only after 3 months of treatment.

What about uterus removal, if I do not want a child?

In case there are tumors in uterus or ovary, then uterus removal is the only choice. However, since it is a major procedure, the decision for this surgery should be carefully weighed and taken. Risk to life is 2 in about 1000 hysterectomies, while about 25% have minor complications like UTI.

What is Open or Laparoscopic surgery?

Laparoscopic surgery, also called minimally invasive surgery (MIS) or keyhole surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions as compared to the larger incisions needed in traditional surgical procedures. Open surgery typically requires an incision large enough for the surgeon's hands to enter the patient. The choice is of type of surgery depends on the surgeon, the findings of your examination, associated medical problems, history of previous surgeries, and whether the procedure of uterus removal can be done by open technique or by laparoscopy.

Are these procedures covered under Mediclaim?

Yes, these procedures are covered by Mediclaim (Health Insurance Scheme) in India, i.e., Hysterectomy of all types and Uterine Balloon Therapy.

The Team Dr Sharda Jain - HOD Dr Uma Rai – Unit Chief Dr Jyoti Aggarwal – Unit Chief Dr Rekha Agarwal Dr Anita Jain Dr Rini Goyal Dr Ila Gupta

Dr Sushma Dikhit Dr Raj Bokaria Dr Debasis Dutta Dr Jyoti Mishra Dr Pawan Bhasin

Visiting Consultants Dr Shubha Saxena Dr Aruna Saxena Dr Anjana Singh Dr Jigyasa Govil Dr Geeta Sharma Dr Sangeeta Goel Dr Poonam Goyal Dr Nalinee Garg

Dr Manju Barik Dr Sangeeta Gupta Dr Pooja Gupta Dr Shanu Gairola Dr Gunjan Gupta Dr Shalini Agarwal Dr Dimple Gandhi

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