Heavy menstrual bleeding (called menorrhagia) may cause many changes in your life. Every woman's cycle is unique, so it is not easy to determine just how much bleeding is too much. Flow that saturates one tampon or one pad every one to two hours during the menstrual cycle is considered to be menorrhagia. Abnormally heavy bleeding such as this creates tremendous problems to activities of daily living. Patients will alter their work schedules and social calendars to avoid events during their cycle. This reduces the risk of the embarrassment of possibly experiencing excessive flow at an inconvenient time.
Besides the emotional toll of heavy menses, there are also potential health ramifications of menorrhagia. These include anemia or low iron due to a lowered volume of blood in the circulation. This same low volume may produce symptoms of shortness of breath, palpitations, fatigue and even dizziness. Any of these may cause a patient to visit the emergency department and even be admitted to the hospital.
To prevent these from happening to you, we recommend early evaluation of the heavy flow. We will schedule an exam and consultation. You may also need an ultrasound, saline infused sonogram (SIS), possibly endometrial biopsy or in-office Hysteroscopy (placing a small video camera inside the cervix to view the interior of the uterus. Once all necessary tests are done, we formulate a plan that works best for your needs.
The plan would always begin with the least invasive therapies such as medications. Commonly used medicines are NSAID's (which reduce bleeding by 20-30%), medcines to help limit the amount of uterine lining growth each month, and even inserting an IUD, which also limits bleeding.
When severe, surgery may be indicated. The least invasive approaches are always considered first and also depends on completion of child bearing. These include:
Hysteroscopy - possibly with polyp removal
Endometrial Ablation - Novasure, HTA
We always prefer the least invasive method that best fits your needs. And if none of these fit your needs, we offer referral for Uterine Artery Embolization (UAE).